Exams don't usually stress me out, or rather, unduly stress me out. My study habits seem to be sufficient to prepare me for most of them. But yesterday afternoon, we had a big exam for our Principles of Surgery lab. This exam was all about demonstrating that we knew how to do some specific things: how to do a sterile prep, how to put on a sterile gown and gloves and maintain sterility, how to scrub in for a surgery, how to tie suture knots and make different suture patterns, which sutures are used in which situations (this includes suture material, suture diameter, and the type of needle), names of about 40 different surgical instruments (all of them named for dead white men), how to fold gowns, how to wrap a pack, in this case the gown we just folded, for sterilization, and how to bandage and cast. That's a long list, and only about half of what we covered in the lab during the term.
Yesterday was the one and only exam for this lab. It was a long, stressful exam--imagine doing all those things while under microscopic scrutiny, and having points taken off for the very smallest of mistakes. There were tears, oh so many tears. I came close myself.
I have to say that the lab techs and the instructors were extremely clear on what we were expected to know and to do. There were no surprises on this exam. We will be cutting into the abdomens of live animals during our first week back in the fall (spays and neuters), and they want to make sure that we are prepared for that.
Two stations in particular were the source of most points lost and the most tears shed: hand throws with suture (that is, tying knots by hand rather than using tools to help hold and pull suture), and suture patterns, both of which had to be done while wearing surgical gloves. We were told in the clearest of language that we had to perform our one-handed and two-handed knots exactly as they were shown in the videos made by the instructor. I am left handed and want to tie my knots with my left hand, and even with that handicap (pardon the pun), I was able to duplicate the videos. Some of my classmates decided they knew better--lost points. Some of my classmates were so nervous that they dropped the suture while tying it--lost points. Some of my classmates never learned their hand knots--lost lots of points. I made sure that I can tie the knots with 5-0 suture (it's scarily fine) while wearing gloves with my eyes closed. But even that level of preparation didn't stop me from being so nervous that sweat was running out of my gloves, leaving tracks of powder on my arms. (Powdered gloves are no longer used for surgery on living animals so they were all sent down to the teaching lab for us second-years.)
It was the suture pattern station that nearly did me in. We had to make three suture patterns. I did the first two (near-far-far-near and Cushing) and was working on the third, the Ford interlocking, a pleasing pattern used for skin closure. Just as I was pulling the closing knot, my fake skin ripped and the entire pattern pulled out. I started over. The exact same thing happened again as I was trying to tie it off. I put my head down on the table, blinked back some hot tears then took a few deep breaths and started the pattern again. I managed, just barely, to tie it off. I was trembling, sweating, worried that I was burning up precious minutes needed for other stations.
Believe it or not, there were a couple of moments of comedic relief during the exam. We had a lecture and lab on bandaging and casting. One of the instructors put a janky bandage and cast on the front leg of a large, plush tiger, included some radiographs of a fractured ulna from a dog in the exam packet, and asked us to list four things that were wrong with the cast on the tiger. There were far more than four things wrong so I thought that was an extremely fair arrangement.
The surgical scrub station was an unexpected challenge. The technique that you use to scrub in is fairly specific and invariable and we had been given several opportunities to practice it under the watchful eye of a lab tech during the term. This time, we lined up next to the sinks and were blindfolded! We then held our hands up as they were painted with green water-soluble paint. Once that dried, we had to grab our scrub sponges and remove as much of the paint as possible in three minutes. From both hands. In THREE minutes. Did I mention the blindfolds? It was stressful and silly at the same time. And rather disturbing to see how many of my classmates still had green paint on their hands at the end of the exercise.
I managed to only lose two points on the exam (I did something dumb with my gown when putting it on, and I lost a point for not explicitly stating that I wanted a taper needle for a specific application.)
We are at last coming to the end of this second year of vet school. Next week is the last week of the term. We have one final next week and five the following week (and we had a seventh class this term that did not have a final associated with it). We are nearly 50% there!
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