How to Write a Case Report and Case Log for a VTS Application

Applying to become a veterinary technician specialist (VTS) positively impacts the veterinary nurse/technician, their patients, and the profession. The application process is both arduous and exciting. A core part of the VTS application includes the creation of 4 comprehensive case reports and 60 case logs (this number varies by academy).

The case report is a scientific paper that captures the planning, critical thinking, and extent of the knowledge a veterinary nurse/technician has gained while pursuing a VTS credential. The writing, grammar, and presentation of information in the case report must demonstrate these achievements.

The case log portion of the application is a diverse collection of cases encountered over the year. This portion challenges the applicant to condense an entire case or procedure into approximately a paragraph. This requires the VTS applicant to only highlight the important aspects of their patient care.

Recognizing that the VTS applicant may not have previous experience in the creation of these scientific reports, this article aims to assist the future VTS in submitting a comprehensive, professional, and scientific packet. Individual requirements vary between specialty academies; please ensure the below recommendations align with the specific instructions and directions of the academy of interest.

Choosing Cases for Case Reports

How does a VTS applicant choose a case to develop into a report? The veterinary nurse/technician should confirm that they are able to elaborate and support each section required by their preferred academy. It is possible that the most exciting and adrenaline-filled case or procedure may not allow one to adequately detail the scope of the skills or depth of knowledge required for the case.  For example, imagine you are submitting to the Academy of Veterinary Emergency and Critical Care Technicians and Nurses (AVECCTN). A very complex case arrives in your emergency department and, although you are able to perform advanced interventions that help stabilize the patient while bolstering the skills list, you are unable to support the discussion needed to detail the breadth and depth of the case. Recognizing this limitation, case selection criteria should include the ability to:

• Discuss the physiology of the case that demonstrates understanding in your own language
• Display critical thinking to support the reason(s) why a treatment/procedure was initiated
• Collaborate with and inform the doctors responsible for the case
• Detail the planning and preparation needed to avoid complications or obstacles
• Convey your reasoning for using/not using a treatment/intervention that is communicated with the veterinarians managing the case
• Explore and document the possible outcomes in the case discussion sections

Curating a Case Log

The case log assembly requires the same level of diligence and editing as the case reports. This process involves a succinct, heavily abbreviated but detailed overview of cases that represent the extent of an applicant’s specialized skills in the past year. The number of required case logs varies between academies, but it is recommended to submit the maximum number allowed. This technique adds a safety net for the applicant in the event that individual case logs are rejected.  Similar to the criteria to select a case for a report, ideal case logs demonstrate:

• An understanding of the case/procedure performed
• The ability to capture attention to detail (even in routine/standard cases)
• An explanation of what equipment or techniques are used and why
• The correct units of measurement

The Basics of Scientific and Professional Writing

The ability to convey the scope of your advanced skills, knowledge, and abilities relies on your ability to describe and document it in the case reports and case logs. Professional and scientific writing uses elevated language that is well-organized and effective. As a rule, scientific writing does not contain contractions, slang/jargon, and/or common vocabulary. In addition, the use of proper writing mechanics will ensure that the attention to detail exercised in patient care is conveyed in writing. These mechanics include correct grammar, lack of sentence fragments, proper punctuation and spelling, and elimination of redundancy. Lastly, it is also important to confirm the desired font, font size, and formatting required by the academy of interest.

Weasel Words and Hedging

Within the case reports and case logs, the use of accurate, timely, and direct information conveys confidence, understanding, and meaningful insights. Weasel words and hedging are phrases that convey uncertainty and vague noncommittal actions. Weasel words “undermine or contradict” the definition of a word through vague and misleading language (TABLE 1).¹

As a comparison, hedging is the use of terms that indicate a “lack of commitment” to the writing (BOX 1).² The use of these words can weaken the impact of your report while adding ambiguity.³ Appreciating that the case report is the thorough detail of one’s hard work, language should emphasize the confidence and assuredness that was displayed while working with patients.

References and Citations

A proper reference page and in-text citations ensure that the applicant has assembled a cohesive and factually accurate packet. The use of American Psychological Association (APA) formatting is ideal for scientific papers; however, confirm that the academy of interest recommends or requires APA formatting. For example, the Academy of Veterinary Surgical Technicians requires American Medical Association (AMA) formatting. The main purpose of APA formatting is the facilitation of “scientific communication” via the promotion of clear expression and the organization of research.⁴ A complete breakdown of the APA style can be found at apastyle.apa.org and the AMA manual of style can be found at academic.oup.com/amamanualofstyle.

Most academies require a minimum number of references be used in case reports. For example, the Academy of Internal Medicine for Veterinary Technicians (AIMVT) requires case reports to include at least 4 references. In contrast, case reports for the Academy of Veterinary Technicians in Anesthesia and Analgesia (AVTAA) must be written “as if the applicant were explaining all details of the case to another veterinary professional in their own words without the need to quote reference material.”⁵

Voice and Style

The use of active or passive voice and first- or third-person will be used in case logs. Understanding what “voice” to use in one’s writing also helps the reader to understand the author’s participation and role in the case. The style determines which pronouns are used.

The use of active voice in case reports instills connection to one’s writing. This voice allows for more concise and direct language while conveying confidence.⁶ As a comparison, passive voice can be considered vague and complicated.⁶ The use of passive voice is common in medical records.

As a rule, third-person style is written without using “I” or “you” pronouns. As the narrator of the case, actions and interventions are described using third-person pronouns (e.g., he, she, they) or referring to themselves as “the applicant.” An example of this is: “The applicant prepared the patient for an upper and lower GI endoscopic procedure.” The AIMVT requires applicants to submit case reports using the third person. Alternatively, the AVECCTN allows their applicants to use first-person statements. Review the requirements of your preferred academy to ensure the correct voice and style are used.

TABLE 2 details the differences between active first-person, active third-person, and passive voice.

How to Elevate Your Language and Vocabulary in a Case Report

The level of medicine used to assemble a VTS application requires and exemplifies advanced medicine and techniques. The language and grammar used to explain these lifesaving and lifechanging measures should match. This dignified and professional language highlights the importance of the work performed. Although this technique may add extra words to the case report, the reader will be able to comprehend that your writing abilities match your advanced technical skills. TABLE 3 details how similar takeaways have more impact with elevated language.

Editing of Case Reports

A pivotal component of writing a successful case report is the opportunity to obtain feedback from peers and colleagues. FIGURE 1 details the additions and edits added to a case report written by a VTS candidate pursuing specialization in neurology. The candidate’s application was accepted, and they passed the exam. By reviewing the track changes in the document, you can appreciate where the language was elevated. Prior to the edits, the case report lacked the inspiration and feeling that is accompanied by the use of an active first- or third-person voice. This was achieved by making the changes outlined in TABLE 4.

It is also possible to appreciate where the editor questioned the patient history. This was not done to dispute the veterinarian’s treatments or diagnostics; it was done to confirm that the applicant understood the reasoning and outcome of these interventions.

Dos and Don’ts of Case Logs

Echoing the recommendations from above, the case log section of the VTS application requires a large amount of information in a limited space. Each VTS academy requires its applicants to submit their case logs that provide an abbreviated but thorough overview of cases seen during the year. Due to limited space, this is an ideal time to use passive voice. TABLE 5 provides an overview of the key aspects that should be considered for each case log.  As a comparison, see FIGURE 2 for an example of an ideal case log for the AVTAA. In the summary of care section, the entirety of an 80-minute case is distilled into a single paragraph.  Despite the limited space, the inclusion of information such as, “pt wrapped in bubble wrap under Bair Hugger” shows attention to detail and the thoroughness needed to demonstrate VTS-level patient care.

Summary

The production of a VTS application is an exciting opportunity to present the scope of one’s advanced skills and knowledge. Similar to the care and attention exhibited while learning the advanced and difficult skills, the VTS application should display the same level of attention. Most importantly, these advanced skills required practice until they were mastered; viewing the VTS application in the same capacity allows an understanding that a first and even second or third draft will likely need to be edited and reviewed. Although this process can be filled with stress and even frustration, it is a very worthwhile endeavor.

Contact the author at HCarter@PartnerVESC.com for resources or help with your VTS application.