Veterinary graduates acquire many diagnostic and therapeutic skills during four or more years of study and are eager to apply their new knowledge to the diagnosis and treatment of complicated diseases like diabetes, hyperadrenocorticism, congestive heart failure and other medical or surgical challenges.

Because these skills and knowledge seem to be the key to addressing health problems of patients, it is surprising — in fact, shocking — when new practitioners realize that, sometimes, technical expertise isn't enough to achieve a satisfactory health-care outcome.

Every veterinary student knows that the profession involves more than dealing with animals. Every interaction with a patient requires an interaction with a human, too. It is, after all, love and concern for their animal companions that induces clients to bring their pets to the veterinary clinic.

Interaction with the client is essential to identifying the problem(s), obtaining permission to do what should be done, engaging the client to participate in the health-care process and, of course, getting paid for all of this.

The skill of teaching

Over the past few years, veterinary educators have begun to acknowledge the importance of teaching communication skills. Most veterinary curricula now include some measure of communication training, and an increasing number of continuing-education venues and journal articles are addressing some communication topics.

Despite the fact that veterinary communication experts recognize that one of the keys to ensuring optimal patient outcomes is effective client education, one aspect of that still receives scant attention: the skill of teaching.

There is an assumption that client education is achieved by just telling the client what needs to be done and perhaps handing out a relevant brochure. If the real measure of success of the communication between veterinarian and client is that the patient receives necessary health care, then we may not be doing a very good job of educating our clients.

The surprising and sad results of the 2003 AAHA compliance study demonstrated that clients were not adhering to recommended actions to the degree presumed by veterinarians. Much of this poor adherence has been attributed to inappropriate or deficient hospital processes, such as scheduling, sending reminders, developing and applying follow-up protocols and other practice-management tools. Certainly, these tactics can have an effect when the problem is forgetfulness on the part of the client or inadequate information provided by the veterinarian or veterinary staff.

But might the issue be something more basic? Do our clients really learn what they are supposed to be doing?

Before clients reliably adhere to a recommended course of action, they must know what they are supposed to do and why. Unfortunately, getting this across to them is more complicated than just "telling." It does not require a Master's degree in education to be an effective client educator, but it is important to understand the principles of adult learning and to be able to customize the message according to the client's unique learning and communication styles.

This first article in a series of three will demonstrate how to apply the principles of adult learning during client communication.

Although some clients may introduce the pet as belonging to a child, the adult is the final arbiter of health-care decisions. When a child is involved, it is important to ensure that the child understands proper care for the pet, but in almost all cases the adult will be the mentor, the reminder, the enforcer and the ultimate caretaker of the pet.

Obviously, it is imperative that the adult be thoroughly educated about the animal's needs and be motivated to meet them. Adults learn differently than children. The term andragogy is used to differentiate the principles of adult learning from pedagogy, which refers to teaching children. There are six basic assumptions upon which andragogy is based. Each can be modified to make them relevant to effective education of clients. They are: