“We are not taught to be good at carrying out death: No one taught us how to walk into an examination room for a euthanasia appointment, what to say to a crying teenager, or whether to hug the elderly man who just lost the pet that was the last link to his late wife,” wrote Mary Gardner, DVM, and Dani McVety, DVM, in “Handling Euthanasia In Your Practice” in the January/February 2016 issue of Today’s Veterinary Practice. The authors, who co-founded Lap of Love Veterinary Hospice, also noted of a veterinarian’s educational experience: “We never received direct guidance about proper verbal and nonverbal techniques that make this ‘most difficult appointment’ just a bit easier on everyone, including the veterinary professional.”
Ariana Boltax, DVM and instructor at Cornell University College of Veterinary Medicine, wanted to change that for her students. She designed the course Small Animal Euthanasia: Clinical Communication and Practice to ensure her students possess crucial skills to enable them to communicate with grief-stricken clients.
“A wise vet once told me that the appointments that pet owners remember most are the pet’s first and the pet’s last,” says Dr. Boltax. “The euthanasia experience is profoundly impactful on both clients and on veterinarians, yet research has shown that between one-quarter and one-third of fourth-year veterinary students feel neither competent nor comfortable with the technical and professional skills involved with euthanasia. Building this course was a phenomenal opportunity to fill a void in the veterinary curriculum in areas I’m passionate about, and to innovate the educational experience along the way.”
Dr. Boltax’s course is typically offered to fourth-year veterinary students, but due to the pandemic, this spring it was opened up to third-year students.
The challenges posed by COVID-19 impacted Dr. Boltax’s students suddenly. “When we had to shift all of our in-person communication labs online, I had to think carefully about how to best host the labs using a video-chat software,” she says. “Besides some relatively minor shifts, I don’t think we lost any value in that transition. Instead, it actually led to valuable conversations about the nuances of online/phone versus in-person communication, and it gave students the opportunity to practice telemedicine, which is something that I don’t think is going away anytime soon. Educationally, students are more likely to remember information long-term when it’s taught in an active and engaging fashion. Transitioning my live, interactive lectures to an asynchronous format really forced me to get creative about how to engage students in the learning process.”
The creativity was evident in the students’ projects, says Dr. Boltax. “Veterinary students don’t often have opportunities to be creative in their courses, and it was so humbling to see the phenomenal work they put forward. One student designed an entire hospital focused on end-of-life care and euthanasia using the video game The Sims. Another pair wrote and recorded a beautiful song focused on veterinary compassion fatigue. A group designed a book about pet loss for parents to fill in with their children. Others focused on using design psychology to design an optimal comfort room for euthanasia. Students also produced truly insightful research on topics such as environmental considerations of barbiturate use for euthanasia, and how to facilitate a socially distanced euthanasia during this pandemic.”
The course received recognition beyond Cornell when it earned the grand prize in the COVID Educational Creations Contest, an international competition sponsored by VetMedAcademy, and the course materials were made available to veterinary professionals.
“It is really validating to know that a panel of reviewers saw the same value that I see in the course materials I created, and I’m excited that my materials are now available, free, for veterinary professionals to use with their own students.” she says. “This contest has drawn more attention to the subject of euthanasia communication skills education, and I’m excited for the future innovations that follow this work.”
Dr. Boltax says that as a kid, she was like many of her peers—she loved animals and she wanted to be a veterinarian.
“I really didn’t know what that meant for me until I got to college,” she says. “I went to Brandeis University, a liberal arts research university, and I fell in love with teaching, academic advising, the integration of the liberal arts into science courses. Midway through college, I seriously considered a pathway to undergraduate teaching, but I realized I hadn’t had substantial veterinary exposure yet.”
In 2012, Dr. Boltax worked as an intern at the New England Wildlife Center in South Weymouth, Massachusetts, and also participated in the Tufts Adventures in Veterinary Medicine program. At the time, she wasn’t certain she wanted a career in veterinary medicine. At Brandeis, she was also a student mentor, offering support and advice to STEM Posse scholarship recipients.
“It was through those experiences that I learned that veterinary education is a career option for me,” says Dr. Boltax. “Learning that it was possible to combine my loves of education and veterinary medicine really blew my mind, and I’ve been working to pave that path for myself ever since.”
Learn More
Read: Handling Euthanasia in Your Practice
Read: Bridging the Gap Between Terminal Illness and Euthanasia