This thesis addresses the question of how veterinary students learn to cope with uncertainty in professional practice. There is currently a lack of clarity in discussion of what constitutes effective coping with uncertainty in veterinary practice and indeed how this might be taught or assessed as part of the veterinary education process. This is despite wide recognition that managing uncertainty is central to practice in the health professions, reflected in the fact that the ability to cope with uncertainty is considered a “day one competency” for veterinary surgeons. This research adopted both extensive and intensive perspectives to address the central research question. Orienting concepts were developed form the literature on workplace learning, approaches to clinical uncertainty and individual differences in tolerance of uncertainty and ambiguity. The extensive perspective used a survey study to describe tolerance of ambiguity among veterinary students at a UK veterinary school. On average, ambiguity tolerance did not change during the classroom based part of veterinary training. Individual trajectories were often more erratic and some students moved between the highest and lowest categories during the course of training. Previous education and status as a mature student were both associated with greater tolerance of ambiguity, suggesting that educational and life experiences can produce changes in this disposition. The intensive perspective comprised a qualitative case study, using clinical case discussion recordings and semi-structured interviews to develop an understanding of the mechanisms which influence learning to cope with uncertainty in the context of an international elective placement. Using the language of situated learning theory, learning to cope with uncertainty was described as legitimate peripheral participation in the uncertainty work of a community of practice. Uncertainty work is a novel concept used to describe navigating ambiguity, complexity and risk in professional practice . Using this theoretical framework to draw together findings from both intensive and extensive perspectives suggested the central role of gaining access to uncertainty work in professional learning. Generative mechanisms have been proposed to explain the empirical findings. Access to uncertainty work was negotiated between students and staff in the context of clinical and educational practice. Trust was central to gaining access to uncertainty work, and this was reflected in increasing clinical responsibility. Ambiguity tolerance was described in this context as a disposition of individuals which can influence their engagement with and access to uncertainty work. Through an exploration of the significance of these mechanisms in the context of Veterinary education, implications for curriculum and policy have been highlighted. Although the use of measures of ambiguity tolerance in selection are considered problematic, there can be clear scope to support students in accessing uncertainty work and to highlight encounters with uncertainty work as integral to the professional role, providing opportunities to promote personal and professional development through reflective practice.

The endangered population of Amur tigers (Panthera tigris altaica) in the Russian Far East (RFE) faces an increasing risk of extinction due to infection with canine distemper virus (CDV). Short-lasting CDV infections are unlikely to be maintained in small populations of species with limited connectivity like tigers, where viruses fade out as susceptible hosts are depleted. Multi-host pathogens can persist in more abundant host species that can act as reservoirs of infection for threatened populations. This study combines assessments of host demography, serology and viral phylogeny to establish the relative contribution of domestic dogs and small bodied wild mesocarnivores to the maintenance of CDV, and as sources of infection for tigers. No antibodies were detected among tigers sampled prior to 2000 (n=19), but were measured in 35.7% of tigers in subsequent years (n=56), with at least five discrete transmission events occurring in one well-monitored population. Viral sequences from three tigers and one Far Eastern leopard (P. pardus orientalis) aligned within the Arctic-like clade of CDV, and shared recent common ancestry with viruses from 22 other wild carnivores from the region. Extensive spatial mixing of wild carnivore lineages suggested long chains of transmission consistent with a maintenance population. The exposure of tigers following 2000 coincides with increases in sable (Martes zibellina) numbers and hunting pressure, which could lead to greater pathogen prevalence and potential for spill over from a wild reservoir. The ratio of humans to dogs in rural areas in the RFE are among the lowest in the world (1.73), but the overall number of dogs has been stable during the period of increased CDV exposure in tigers. The only CDV sequence obtained from dogs shared high identity with Asia-4 clade viruses from dogs in Thailand, and was distantly related to wildlife sequences from the RFE. Serum antibodies were detected in dogs in all 26 communities where households were surveyed, but seroprevalence was higher in remote, less densely populated areas, suggesting possible transmission from wildlife. Although the maintenance of CDV in Russian dogs remains unconfirmed, the strong support for a wildlife reservoir limits options for managing the impact of CDV on tiger populations. The high turnover of large and often inaccessible populations of mesocarnivores combines with limitations in vaccine safety, efficacy and delivery, to render the control of CDV in a wildlife reservoir untenable. Managing the impact of CDV on Amur tigers must therefore focus on restoring the size and integrity of remaining tiger populations to withstand future outbreaks. The safety and efficacy of vaccine products for tigers should also be investigated, for use in low coverage vaccination strategies that could enhance the long-term persistence of tiger populations.