AECs considering the use of animals for postgraduate surgical training

General

In both the human and veterinary fields there continue to be developments and advances in surgical technologies. Because of such developments there remains a need to teach practitioners new skills.

Animals are not used to train undergraduate medical students in surgical procedures but they are used for surgical training of undergraduate veterinary students. It is recognised that there is a place for the use of animals in postgraduate surgical training.

The use of animals for postgraduate surgical training must conform to the requirements of the Code of Practice under the Animal Research Act Regulation and therefore cannot be carried out without the approval of an ACEC.

Institutions may wish to develop their own policies for dealing with issues of postgraduate surgical training.

These guidelines do not address the postgraduate surgical training of veterinarians in a clinical situation where procedures are performed for the benefit of individual animals. In such situations it must be the responsibility of the supervising veterinarian to ensure the welfare of the animals under his or her care.

1. Justification

1.1 As for any application to conduct animal research, clear justification for the need to use animals should be provided. The need to use a particular species of animal must also be justified.

Assessment of the justification necessarily involves an assessment of the educational value of the procedures. The extent of knowledge and experience of the procedures within the relevant Profession must also be assessed.

1.2 Suitable justification may include:

• areas where new skills or knowledge are being developed.

For example the development of new surgical procedures or the demonstration of new surgical procedures for which there is not existing expertise. A practical example of this would be a visiting overseas surgeon demonstrating a technique that had not been used in Australia.

• the demonstration of techniques to practitioners who would not normally have the opportunity to work with specialists in the procedures being demonstrated.

For example the demonstration of lifesaving techniques (such as cricothyroidotomy) to general medical practitioners.

1.3 Procedures for which justification should be carefully evaluated include:

• the demonstration of techniques that could be taught in a clinical setting.
• workshops where the demonstrator of techniques is not a clinical surgeon (medical or veterinary).

1.4 Procedures for which justification would not be acceptable would include workshops held for purely promotional or commercial reasons.

1.5 Justification should include reasons why alternatives to animal use were not possible. Possible alternatives include:

• dry workshops to familiarise surgeons with the handling of instruments
• the use of tissues from cadavers (for example from abattoirs)
• te use of videos and computer program training methods.

1.6 The use of animals for surgical training does not usually require that animals recover from anaesthesia. Special consideration must be given to protocols where it is proposed that animals will be allowed to recover. The justification for such protocols must be compelling. The obligation is on the applicant to provide a strong case for the need to allow animals to recover.

The justification should take into account the degree of invasiveness of the procedure[s] and the likely impact on animals used.

Procedures and management must be in accord with the principles in the Code of Practice that deals with surgical procedures and post operative care in detail. Post operative management should receive particular scrutiny. Details of the time animals are to be held post-operatively and their eventual fate must also be considered.

1.7 As with all uses of animals in research, assessment of the scientific or educational benefits must include an evaluation of the qualifications of all people involved relevant to the procedures to be undertaken.

Where the species of animal used is not that for which the technique is intended (eg demonstration on pigs of techniques to be used in humans) the responsible investigators should properly explain their appreciation of the relevance of species differences.

1.8 For larger institutions which may be approached by outside groups to conduct workshops, a practical means of ensuring the educational value of the workshop would be to obtain the assessment of a senior clinician (or senior academic) from the institution. This person should have expertise in the area.

1.9 The chief investigator should be responsible for and have qualifications appropriate to, the educational value of the procedures. For surgical workshops the chief investigator should be a surgeon (medical or veterinary) with particular expertise in the area.

1.10 Consideration should be given to the number of instructors and their qualifications. Instructors should have clinical expertise in the field being demonstrated. Company representatives may be present in order to assist with technical matters relating to equipment but must not be in control of the conduct of the workshop.

2. Numbers of Animals

2.1 The number of animals used must be justified and the minimum number used in accordance with the requirements of the Code of Practice. Points to consider in assessing the number of animals include the educational objective and the number of participants in the workshop. Protocols must provide information on the number of workshops to be conducted, the number of animals to be used and the number of people to be trained.

3. Monitoring of Animals

3.1 Management and care of animals must be in compliance with the Code of Practice.

3.2 Pre-operative considerations include the adequacy of facilities for animal transport and housing and the area used for induction of anaesthesia. Pre-operative handling and management must take into consideration the physiological and social needs of the species (for example, times required for pre-operative fasting and the avoidance of social isolation of sheep and pigs).

3.3 Choice of anaesthetic agents (including methods of induction of anaesthesia) must be appropriate for the procedure to be performed and the species.

3.4 Animals under anaesthesia must be adequately monitored in compliance with the Code of Practice. Consideration should include the numbers of people available to monitor anaesthetic depth and the qualifications of these people.

3.5 There should be at least one anaesthetist with appropriate experience in veterinary anaesthesia and substantial expertise in anaesthetising the species to be used.

3.6 The ACEC should be assured there is adequate equipment available to maintain and monitor anaesthesia in all animals used.

3.7 Consideration should be given to the suitability of the venue in which the workshop is to be conducted and the number of participants that can properly be accommodated in the chosen venue.

4. Conduct of Participants in Workshops

4.1 An accredited institution is responsible for teaching activities which are conducted on its designated land. As with all research using animals the supervising ACEC may monitor the progress of the workshop at all stages, with or without prior notification.

4.2 Instructors must ensure that the workshop is conducted in accordance with ACEC requirements and in compliance with the Code of Practice.

4.3 Participants must be instructed about their responsibilities concerning animal welfare and the Animal Research Act prior to the commencement of the workshop. Participants must agree to accept these responsibilities.

4.4 It is important that the attitude of participants is one of respect for the animals being used. Inappropriate conduct should be firmly dealt with by instructors or workshop coordinators.

Acknowledgments: The comments of the following groups during the development of these guidelines are gratefully acknowledged: NH&MRC, University of Sydney ACEC, University of NSW ACEC, University of Newcastle ACEC, Board of Veterinary Surgeons of NSW, University of Sydney Faculty of Veterinary Science, Australasian College of Surgeons.