Clinical reasoning is the skill used when veterinary surgeons make a decision regarding the diagnosis, treatment plan or prognosis of a patient. Despite its necessity and ubiquity within clinical practice, very little is known about the development of clinical reasoning during undergraduate training. Even less is understood about how veterinary schools should be helping students improve this skill. The aim of the research presented within this thesis was to, firstly, examine the development of clinical reasoning ability within veterinary students and, secondly, to investigate possible methods to aid this process. The University of Nottingham School of Veterinary Medicine and Science (SVMS) was used as a case study for this research. In study one, focus groups and interviews were conducted with SVMS staff, students and graduates to investigate the development of clinical reasoning. A curriculum document content analysis was also performed. The findings suggested that clinical reasoning development is not optimal, with alumni facing a steep learning curve when entering practice. These results were used to design study two, in which a simulated consultation exercise utilizing standardised clients was created and implemented for final year students. The success of the simulation was measured using both quantitative and qualitative methods – all of which supported the use of the session for clinical reasoning development. The final study, also building on the findings of study one, aimed to improve the accessibility of veterinary surgeons’ decision-making processes during student clinical extramural studies placements (CEMS). A reflective Decision Diary was created and trialled with third and fourth year SVMS students. Diary content analysis showed the study aim was met, triangulated by survey and focus group findings. During the research, wider issues relating to clinical reasoning integration into veterinary curricula were unearthed. These included low student awareness of the subject and the misalignment between the skill learnt during training and the skill required when in practice. Several recommendations have been made to improve the design of the undergraduate curriculum in relation to clinical reasoning.

Examining patient records is a useful way to identify common conditions and treatment outcomes in veterinary practice and data gathered can be fed back to the profession to assist with clinical decision making. This research aimed to develop a method to extract clinical data from veterinary electronic patient records (EPRs) and to assess the value of the data extracted for use in practice-based research. The transfer of new research from continuing professional development (CPD) into practice was also considered. An extensible mark-up language (XML) schema was designed to extract information from a veterinary EPR. The analysis of free text was performed using a content analysis program and a clinical terms dictionary was created to mine the extracted data. Data collected by direct observation was compared to the extracted data. A review of research published in the proceedings of a popular veterinary CPD event, British Small Animal Veterinary Association (BSAVA) Congress, was appraised for evidence quality. All animal records were extracted and validation confirmed 100% accuracy. The content analysis produced results with a high specificity (100%) and the mined data analysis was successful in assessing the prevalence of a specific disease. On comparison, the data extracted from the EPR contained only 65% of all data recorded by direct observation. The review of BSAVA Congress abstracts found the majority of the clinical research abstracts (CRAs) presented to be case reports and case series, with differences in focus between CRAs and veterinary lecture stream abstracts. This study has demonstrated that data extraction using an XML schema is a viable method for the capture of patient data from veterinary EPRs. The next step will be to understand the differences found between data collected by observation and extraction, and to investigate how research presented as CPD is received, appraised and applied by the veterinary profession.