ESSENTIAL SKILLS CHECKLIST

PURDUE UNIVERSITY
VETERINARY NURSING

August 2022

Purdue University is an equal access/equal opportunity/affirmative action university.

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 STUDENT NAME ___________________________________________

Student Responsibilities for the Task Checklist Book

 Be proactive about informing instructors of tasks you need to
perform

 Bring book to all labs and clinical rotations to facilitate

completion of tasks and signatures

 Obtain signatures in a timely manner

 Enter dates and printed names for each task. You are responsible
for these, and to be sure the printed name is legible

 Submit book to Clinical Coordinator as requested for periodic

progress checks

 Protect book through labs and clinical rotations to submit upon

completion of clinical portion of the Associate degree program

This documentation is required by the AVMA for every graduate of the program, and is
required for completion of the final clinical rotation course.

Temperature Heart Rate Respiration

Dog 99.5-102.5 80-120 15-30
Cat 100-103 160-220 20-30
Horse 99-101 28-40 10-14
Cattle 100-102.5 55-80 10-30
Swine 100.5-104 60-90 8-18
Sheep 101-104 55-115 10-30
Goat 101-104.5 70-120 10-30
Ferret 100-102.5 300 33-36
Rabbit 100.5-105 120-150 50-60
Llama 99.5-102 60-90 10-30

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 Table of Contents

Restraint Page

Small Animal

Encage and Remove Dog from Cage 8

Encage and Remove Cat from Cage 8
Canine Sternal Recumbency Restraint 8
Canine Lateral Recumbency Restraint 8
Canine Cephalic Venipuncture Restraint 9
Canine Saphenous Venipuncture Restraint 9
Canine Jugular Venipuncture Restraint 9
Canine Eye / Ear Medication Restraint 10
Canine IM Injection or Nail Trim Restraint 10
Canine Gauze Muzzle Application 10
Canine Nylon / Leather Muzzle Application 11
Restraint Pole Use 11
Feline Cephalic Venipuncture Restraint 11
Feline Jugular Venipuncture Restraint 12
Feline Sternal Recumbency “Cat Press” Restraint 12
Feline Lateral Recumbency “Cat Stretch” Restraint 12
Feline Towel Restraint 13
Feline Muzzle Application 13
Feline Cat Bag Restraint 13

Large Animal

Participate in Safe Operation of Cattle Chute 14

Halter Placement in the Bovine Patient 14
Application of Tail Restraint in the Bovine Patient 14
Haltering, Tying and Leading the Horse 15
Attaching and Using a Chain Lead with the Halter in Place 16
Attaching a Chain or Rope Nose Twitch to a Haltered Horse 16
Snare Restraint of the Porcine Patient 17
Herding or Moving of the Porcine Patient 17
Herding and Capturing the Ovine/Caprine Patient 17
Restraint of the Ovine/Caprine Patient 18

Lab Animal

Restrain Rat by Grasping Over Shoulders for Oral Exam/Injection 19

Handle Rat by Grasping Base of Tail 19
Administer Oral Drug / Medication to Rat 19
Administer Intraperitoneal Injection to Rat 20
Administer Subcutaneous Injection to Rat 20
Collect Blood from Rat 20
Restrain Rabbit in Towel with Head Exposed 21
Restrain Rabbit for Physical Exam and Sex Determination 21
Restrain Rabbit in Cat Bag or Commercial Rabbit Restrainer 21

3
Administer Subcutaneous Injection to a Rabbit 22
Collect Blood from a Rabbit 22
Restrain Bird and Perform Physical Examination 23
Trim Nails on a Bird 23

Small or Large Animal Tasks

Obtain a History 24
Recording Patient Treatment/Clinical Data on Hospitalized Patient 24
Participate in an Enema (Small or Large Animal) 25

Small Animal Tasks

Perform a Physical Examination on a Canine Patient 25

Perform a Physical Examination on a Feline Patient 26
Administer Oral Tablet or Capsule to Dog 26
Administer Oral Tablet or Capsule to Cat 27
Administer Oral Liquid to Dog or Cat 27
Administer Eye Drops or Ointment to a Dog or Cat 27
Administer Ear Medication to Dog 28
Administer Ear Medication to Cat 28
Administer Subcutaneous Injection to Dog 28
Administer Subcutaneous Injection to Cat 29
Administer Intramuscular Injection to Dog 29
Administer Intramuscular Injection to Cat 29
Perform Cephalic Venipuncture in a Dog 30
Perform Cephalic Venipuncture in a Cat 30
Perform Saphenous Venipuncture in a Dog 30
Perform Femoral/Medial Saphenous Venipuncture in a Cat 31
Administer Intravenous Cephalic Injection to a Dog 31
Administer Intravenous Saphenous Injection to a Dog 31
Administer Intravenous Injection to a Cat 32
Trim Toe Nails in a Dog 32
Trim Toe Nails in a Cat 32
Ear Sample Collection and Preparation in a Dog or Cat 33
Clean Ears in a Dog 33
Clean Ears in a Cat 33
Express Anal Sacs in a Dog 34
Bathe a Dog or Cat 34
Collect a Free Catch Urine Sample from a Dog or Cat 34
Perform Jugular Venipuncture in a Dog 35
Perform Jugular Venipuncture in a Cat 35
Place a Cephalic Catheter in a Dog 35
Place a Cephalic Catheter in a Cat 36
Place a Saphenous Catheter in a Dog 36
Apply and Remove a Modified Robert Jones Bandage 36
Administer Subcutaneous Fluids to a Dog or Cat 37
Perform Cystocentesis in a Dog or Cat 37
Place a Urinary Catheter in a Male Dog 37
Collect and Prepare Vaginal Cytology – Canine 38

4
Place a Stomach Tube in a Dog or Cat 38
Perform a Comprehensive Oral Health Assessment/Treatment in a Dog or Cat 39
Perform a Skin Scraping 40
Perform Visual Exam for External Parasites 40
Collect a Sample for Dermatophyte Culture & Inoculate Media 40
Perform a Schirmer Tear Test 41
Perform a Fluorescein Stain Test 41
Perform Tonometry 41
Application of Elizabethan Collar 42
Apply Emergency Bandage or Splint 42
Hospitalized Patient Care, Recordkeeping & Observation of a Critical Patient 43
Calculate, Monitor and Maintain Intravenous Fluids and IV Catheter Care 43
Closed-Chest Cardiopulmonary Resuscitation (CPR) – Small Animal 44

Large Animal Tasks

Perform a Physical Examination in a Bovine Patient 44

Perform a Physical Examination in an Equine Patient 45
Perform Jugular Venipuncture in a Bovine Patient 45
Administration of Intravenous Injection in a Bovine Patient 46
Administration of Subcutaneous Injection in a Bovine Patient 46
Administration of Liquid Medication in a Bovine Patient 46
Administration of Bolus Medication in a Bovine Patient 47
Perform Jugular Venipuncture in an Equine Patient 47
Administration of Intravenous Injection an Equine Patient 47
Administration of Intramuscular Injection in an Equine Patient 48
Administration of Liquid Medication in an Equine Patient 48
Collect Milk Sample and Perform California Mastitis Testing 48
Apply Lower Leg Wrap in an Equine Patient 49
Apply Tail Wrap in an Equine Patient 49
Place Jugular Intravenous Catheter in a Large Animal 50

Anesthesia Tasks

Anesthesia Record Procedures – Large or Small Animal 50

Small Animal

Anesthetic Delivery & Monitoring Equipment Use and Maintenance 51

Pre-Anesthetic Preparation of the Anesthetic Machine 51
Preparation of Supplies Prior to General Inhalant Anesthesia 52
Pre-Anesthetic Preparation of the Patient for Anesthesia 53
Induction by Injectable Agent 53
Intubation of a Dog 54
Intubation of a Cat 54
Maintenance and Monitoring of General Anesthesia 55
Recovery from General Anesthesia 56

5
Operating Room and Sterilization Tasks

Post-Surgical Clean Up and OR Sanitation and Care 57

Clean Instruments Post-Operatively 57
Prepare a Surgical Pack for Sterilization 57
Sterilize an Instrument Pack 58
Sterilize an Individually Packaged Instrument or Item 58
Open a Surgical Pack 59
Open a Gown and Gloves 59
Position Patient for Procedures and Express Urinary Bladder 59
Participate in Ovariohysterectomy in a Dog 60
Participate in Ovariohysterectomy in a Cat 60
Participate in Orchiectomy in a Dog 60
Participate in Orchiectomy in a Cat 60
Clip and Prepare a Surgical Site 61
Scrubbing of Arms and Hands for Surgery 61
Aseptically Don Surgical Gown 62
Perform Closed Gloving Technique as a Scrub Nurse 62
Aseptically Pass Instruments as a Scrub Nurse 63
Provide Aseptic Surgical Assistance with Care of Exposed Tissues 63
Aseptically Pass Instruments as the Circulating Nurse 64
Operate and Maintain Suction and Cautery Machines 64
Removal of Sutures 65

Pharmacy Tasks

Complete Controlled Substance Log 65

Medication Labeling 65
Filling an Oral Solid Medication 66
Filling a Liquid Medication 66
Reconstitute a Medication for Dispensing 66
Reconstitute a Vaccine 67
Dispense Medication to the Client 67

Necropsy Tasks

Assist in or Perform Prosection on Non-Preserved Animal 68

Collection, Preservation and Shipping of Samples 69

Clinical Pathology Tasks

Packed Cell Volume 70

Total Protein 71
Blood Film Preparation 72
Differential 73
Modified Manual CBC 73
Automated CBC 74
Coagulation Test 74
Prepare Serum and Plasma 74

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Chemistry Panel 75
Collect and Crossmatch Blood for Transfusion 75
Urinalysis 75
Serology 76

Other Diagnostic Tasks

Streak Agar Plate to Obtain a Pure Culture 76

Urine Sample for Culture and Inoculation of Broth 76
Prepare a Gram-stained Slide 77
Perform Catalase Test 77
Perform Oxidase Test 78
Perform Kirby-Bauer Disc Sensitivity Test 78
Perform and Read Direct Fecal Smear 79
Perform and Read Fecal Flotation 79
Perform by Centrifugation and Read Fecal Flotation 80
Perform and Read Fecal Sedimentation 80
Perform Heartworm Diagnostic Test (antigen, direct, Knott’s) 81

Imaging Tasks

Safety Procedures 82
Complete Radiology Log 82
Participate in Contrast Study 82
Lateral and Ventrodorsal Thoracic Radiograph 83
Lateral and Ventrodorsal Thoracic Radiograph 83
Lateral and Ventrodorsal Abdominal Radiograph 84
Lateral and Ventrodorsal Abdominal Radiograph 84
Ventrodorsal Extended Pelvis Radiograph (OFA View) 85
Create Diagnostic Intra-Oral Dental Radiographic Images 85
Lateromedial Projection of the Metacarpophalangeal (Fetlock) 86
Dorsopalmar Projection of the Metacarpophalangeal or Dorsoplantar Projection 86
of the Metatarsophalangeal (Fetlock)

7
 Encage and Remove Dog from Cage

Date completed ____________________________

 The student safely and appropriately approached the cage and opened the door
 The student was able to remove the dog from the cage without injury to themselves or the patient
 The student properly returned the dog to the cage without injury to themselves or the patient
 The student safely and appropriately closed and secured the cage door

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Encage and Remove Cat from Cage

Date completed ____________________________

 The student safely and appropriately approached the cage and opened the door
 The student was able to remove the cat from the cage without injury to themselves or the patient
 The student properly returned the cat to the cage without injury to themselves or the patient
 The student safely and appropriately closed and secured the cage door

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Canine Sternal Recumbency Restraint

Date completed ____________________________

 The student properly positioned the dog in sternal recumbency

 The student was able to restrain the animal when it struggled
 The student properly positioned their hand and arm around the neck and head so as to control the head and
prevent personnel from being bitten or injured
 The student properly positioned their hand, arm and body to keep the body of the animal properly immobilized
so as to prevent personnel from being injured
 The student was able to restrain the animal in a manner that was adequate for control yet of no harm to the
animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Canine Lateral Recumbency Restraint

Date completed ____________________________

 The student properly positioned the dog in a lateral recumbency

 The student was able to restrain the animal when it struggled
 The student properly positioned their hands, arms and body to keep the body of the animal properly
immobilized so as to prevent personnel from being injured
 The student was able to restrain the animal in a manner that was adequate for the control yet of no harm to
the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

8
 Canine Cephalic Venipuncture Restraint

Date completed ______________________________

 The student was able to restrain the animal when it struggled

 The student was able to apply a tourniquet or compress the vein in order to raise the vein so that
venipuncture could be done successfully
 The student released the tourniquet or removed the compression on the vein to prevent excessive
bleeding after completion of the venipuncture
 The student applied pressure to the venipuncture site so as to prevent bleeding from the site
 The student was able to restrain the animal in a manner that was adequate for control yet of no
harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Canine Saphenous Venipuncture Restraint

Date completed _______________________________

 The student was able to restrain the animal when it struggled

 The student was able to apply a tourniquet or compress the vein in order to raise the vein so that
the venipuncture could be done successfully
 The student released the tourniquet or removed the compression on the vein to prevent excessive
bleeding after completion of the venipuncture
 The student applied pressure to the venipuncture site so as to prevent bleeding from the site
 The student was able to restrain the animal in a manner that was adequate for control yet of no
harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Canine Jugular Venipuncture Restraint

Date completed ______________________________

 The student was able to restrain the animal when it struggled

 The student positioned the animal’s head to facilitate access to the vein
 The student applied pressure to the venipuncture site so as to prevent bleeding from the site
 The student was able to restrain the animal in a manner that was adequate for control yet of no
harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

9
 Canine Eye / Ear Medication Restraint

Date completed _______________________________

 The student was able to restrain the animal when it struggled such that the medication was
successfully administered and the applicator tip did not touch the animal
 The student kept the nose tipped up and/or the head adequately controlled so that the medication
was successfully administered without contamination of the applicator tip
 The student was able to restrain the animal in a manner that was adequate for control yet of no
harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Canine IM Injection or Nail Trim Restraint

Date completed ______________________________

 The student was able to restrain the animal when it struggled such that personnel were able to
carry out the IM injection or nail trim procedure without being bitten or injured
 The student was able to restrain the animal in a manner that was adequate for control yet of no
harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Canine Gauze Muzzle Application

Date completed _______________________________

 The gauze is of appropriate length to wrap around and tie top of the muzzle, tie beneath the dog’s
muzzle, and still have sufficient length to tie in a bow behind the head
 The gauze muzzle was placed appropriately on the dog so that the mouth would not open
sufficiently to all biting
 The muzzle was applied in such a way that the animal experienced minimal discomfort

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

10
 Canine Nylon / Leather Muzzle Application

Date completed _______________________________

 The correct muzzle size was selected

 The muzzle was placed on the dog correctly
 The muzzle was placed appropriately on the dog so that the mouth would not open sufficiently to
allow biting
 The muzzle was applied in such a way that the animal experienced minimal discomfort

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Restraint Pole Use

Date completed _________________________________

 The student verified that the restraint pole is in good working order
 The student properly placed the loop over the patent’s head and around the neck
 The student closed the loop around the animal’s neck such that the animal could not escape, but
breathing was not restricted
 The student safely removed the restraint pole from the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Feline Cephalic Venipuncture Restraint

Date completed ________________________________

 The student was able to restrain the animal when it struggled

 The student was able to apply a tourniquet or compress the vein in order to raise the vein so that he
venipuncture could be done successfully
 The student released the tourniquet or removed the compression of the vein to prevent excessive
bleeding after completion of the venipuncture
 The student applied pressure to the venipuncture site so as to prevent bleeding from the site
 The student was able to restrain the animal in a manner that was adequate for control yet of no
harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

11
 Feline Jugular Venipuncture Restraint

Date completed ________________________________

 The student was able to restrain the animal when it struggled

 The student positioned the animal’s head to facilitate access to the vein
 The student applied pressure to the venipuncture site so as to prevent bleeding from the site
 The student was able to restrain the animal in a manner that was adequate for control yet of no
harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Feline Sternal Recumbency “Cat Press” Restraint

Date completed _________________________________

 The student properly positioned the cat in sternal recumbency by holding the scruff of the neck and
pressing down on the cat with their other hand
 The student was able to restrain the animal when it struggled
 The student was able to control the head so as to prevent the other person or themselves from
being bitten or injured by movement of the head
 The student was able to control the feet so as to prevent the other person or themselves from being
scratched or injured by the claws
 The student was able to move so as to allow the other person to successfully perform a physical
examination, but was able to maintain control of the animal
 The student was able to restrain the animal in a manner that was adequate for control yet of no
harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Feline Lateral Recumbency “Cat Stretch” Restraint

Date completed _________________________________

 The student properly positioned the cat in lateral recumbency with one hand on the scruff of the
neck and the other controlling the rear legs
 The student was able to restrain the animal if it struggled
 The student was able to control the head so as to prevent the other person or themselves from
being bitten or injured by movement of the head
 The student was able to control the feet so as to prevent the other person or themselves from being
scratched or injured by the claws
 The student was able to move so as to allow the other person to successfully perform the physical
examination, but was able to maintain control of the animal
 The student was able to restrain the animal in a manner that was adequate for control yet of no
harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

12
 Feline Towel Restraint

Date completed ______________________________

 The student properly positioned the cat in sternal recumbency on the towel
 The student positioned the cat so that it was perpendicular to the length of the towel with its head
off the edge of the towel
 The student was able to wrap the cat in the towel to control the head so as to prevent other person
or themselves from being bitten or injured by movement of the head
 The student was able to wrap the cat in the towel to control the feet so as to prevent the other
person or themselves from being scratched or injured by the claws
 The student was able to restrain the animal in a manner that was adequate for control yet of no
harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Feline Muzzle Application

Date completed ____________________________

 The correct muzzle size was selected

 The muzzle was placed on the cat correctly
 The muzzle was applied in such a way that the animal experienced minimal discomfort

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Feline Cat Bag Restraint

Date completed ___________________________

 The student properly positioned the cat in sternal recumbency in the open bag
 The student was able to close the bag with the cat inside the cat bag so as to prevent the other
person or themselves from being bitten or injured by movement of the head
 The student was able to close the bag with the cat inside so as to prevent the other person or
themselves from being scratched or injured by the claws
 The student was able to restrain the animal in a manner that was adequate for control yet of no
harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

13
 Participate in Safe Operation of Cattle Chute

Date completed _________________________________

 The student participated in the safe operation of a cattle chute

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Halter Placement in the Bovine Patient

Date completed ________________________________

 The student observed the patient from a distance

 The student approached the patient calmly and quietly
 The student approached the patient from the left side while verbalizing, so the patient was aware of
the student
 The student took the appropriate steps to calm the patient if it became uneasy
 The student approached the patient and placed the halter on the far ear
 The student placed the halter on the near ear
 The student placed the muzzle into the halter with the lead under the chin and on the patient’s left
side
 The student completed the final adjustments to the halter so that the halter was comfortable to the
patient and was useful to the student

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Application of Tail Restraint in the Bovine Patient

Date completed _________________________________

 The student approached the patient already in the stocks

 The student grasped the tail close to the base and lifted it over the back of the patient
 The student restrained the distal end of the tail so they were not hit in the face with it
 The student applied pressure to the tail, continuing to take it straight over the patient’s spine without
causing injury to the patient
 The student relaxed the hold on the tail as desired when the second person was not actively in
danger
 The student released the tail of the patient and stepped away

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

14
 Haltering, Tying and Leading the Horse

Date completed ____________________________________

 The student positioned the unbuckled halter, in their left hand, for placement on the horse, with the
non-snap end of the lead rope in their right hand
 Without quick movements and loud noises the student properly approached the patient at a 45°
angle to the patient’s left shoulder
 The student placed the end of the lead over the horse’s neck, and passed sufficient length of lead
to form a handheld loop around the horse’s neck
 Holding the handheld loop in their right hand, with their left hand, the student slipped the nose-band
of the halter over the nose
 With their right hand under the horse’s neck, the student passed the crown strap over the head and
behind the ears and attached the end to the appropriate place on the halter
 The student snapped the end of the lead to the lead ring of the halter and undraped the lead rope
from the horse’s neck
 The student adjusted the halter so it was snug enough that the nose piece could not fall over the
end of the nose, but not so tight that the halter cut or rubbed the horse or restricted jaw movement
or breathing
 The student did not restrain the horse by holding on the halter
 The student folded the loose end of the lead in an accordion fashion, and held it in their left hand
 The student positioned themselves on the left side of the horse, approximately midway along the
horse’s neck, 12 to 18” from the horse’s body, with their right hand grasping the lead approximately
6 to 12” from the lead ring of the halter
 The student led the horse from the “neck” position
 The student remained alert to the movements and reactions of the horse
 The student did not lead from in front of the horse or lag back allowing the horse to pull them
 The student appropriately tied the lead rope to an acceptable structure, then untied it
 The student removed the halter from the horse and was observant when they walked away from the
horse

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

15
 Attaching and Using a Chain Lead with the Halter Already in Placed on a Horse

Date completed _________________________________

 The student properly approached the left side of the haltered patient
 The student passed the snap end of the lead through the lower left ring of the halter, from outside to
inside
 The student draped the chain over the nose of the horse, just rostral to the nose band of the halter
 The student passed the snap of the lead through the left lower halter ring, from inside to outside
 The student attached the snap with the button side out to the right ring of the halter
 The button of the snap did not rub on the face of the horse
 The chain moved freely through the lower halter rings, across the bridge and below the halter nose
band when drawn tightly or relaxed
 The student removed the chain lead

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Attaching a Chain or Rope Nose Twitch to a Haltered Horse

Date completed __________________________________

 The student properly approached the left side of a haltered horse, held on a lead by the assistant,
positioning themselves forward of the assistant and lateral to the head of the horse
 With their left hand, the student passed their hand part way through the loop of the twitch, so that
their pinky or index finger and thumb were not through the loop and so that the loop would not slide
completely over their hand
 The handle of the twitch was held in the student’s right hand and to the left of the horse
 The student’s hand holding the loop was brought over the bridge of the nose and gently, but without
hesitation, brought down to the upper lip
 The student grasped the upper lip and nose of the patient securely and slipped the loop of the
twitch off the fingers and over the upper lip and nose
 The student twisted the handle of the twitch toward the head (clockwise) until the loop was snug, to
prevent the loop from falling off and to distract the horse, but not so much to cause excessive pain
 The student instructed the assistant to hold the horse’s head to the left with the lead
 The student did not pull the horses head to the left with the twitch
 The student did not stand in front of the horse
 The student applied pressure to the lip with a twist and not a pull
 The student altered the pressure on the lip with a rocking motion, slightly releasing and re-tensing
the tension on the loop
 The student kept both hands on the twitch during the procedure
 The student released the twitch and rubbed the horse’s upper lip and nose

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

16
 Snare Restraint of the Porcine Patient
Date completed _______________________________

 The student observed the patient from a distance

 The student made sure that the pen is the correct size for snaring the patient
 The student made sure the loop in the snare was large enough to go over the patient’s nose and
into the mouth
 The student approached the patient on the side calmly and quietly
 The student, standing next to the patient, guided the loop of the snare into the mouth and over the
nose or upper jaw
 The student made sure the loop is inserted far enough into the patient’s mouth
 The student pulled the loop tight when it is in the proper position
 The student kept the loop tight while moving to the front of the patient
 The student maintained the pressure on the snare so that the patient could not escape
 The student kept control of the patient until the patient ceased to struggle
 The student released the patient after the procedure was completed

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Herding or Moving of the Porcine Patient

Date completed _______________________________

 The student observed the patient from a distance

 The student made sure that the pen is the correct size for moving the patient
 The student moved to the patient keeping the board or panel between themselves and the patient
 The student approached the patient on the side calmly and quietly
 The student guided the patient along the fence from one end of the pen to the other using the board
or panel
 The student kept control of the patient during the process
 The student did not rush the patient but allowed them to move at their own pace
 The student released the patient after moving them around the pen

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Herding and Capturing the Ovine/Caprine Patient

Date completed ___________________________________

 The student observed the patient (or group) from a distance

 The student approached the patient (or group) calmly and quietly
 The student allowed the group to remain together and moved near to the patient within the group
 The student made contact with the patient and firmly grasped around the head or neck area
 The student did not grasp the patient by the wool
 The student kept control of the patient until the patient ceased to struggle

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

17
 Restraint of the Ovine/Caprine Patient

Date completed ___________________________________

Energy Efficient Method

 The student grasped the head or neck with the hand under the jaw
 The student reached over the back of the patient and grasped the hind limb nearest to them
 The student pulled the hind limb ventral and up and at the same time pulled the head of the patient
toward them
 The student stepped back and allowed the patient’s rump to sit on the ground
 The student placed the patient between their legs and allowed the patient to relax
 The student kept control of the patient until the patient ceased to struggle
 The student slowly released the patient, allowed it to roll to its side and stand up
 The student did not at any time grasp the patient by the wood
Alternate Energy Efficient Method
 The student grasped the head or neck with the hand under the jaw
 The student reached under the abdomen of the patient and grasped the hind limb furthest from
them
 The student pulled the hind limb ventral and toward them
 The student used their shoulder to push the patient’s hip and at the same time lifted the patient’s
head causing the patient to sit on their rump with its feet toward the student
 The student stepped around the patient so that the patient’s back is in front of them with the limbs
of the patient pointing away
 The student placed the patient between their legs and allowed patient to relax
 The student kept control of the patient until the patient ceased to struggle
 The student slowly released the patient, allowed it to roll to its side and stand
 The student did not at any time grasp the patient by the wool
The Coordination Method
 The student grasped the head or neck with the hand under the jaw
 The student placed their hand on the patient’s hip that is furthest away
 The student curved the patient’s head to its side with its nose pointed toward its side
 The student pushed down and back on the patient’s hip
 The student stepped back with the foot near the back of the patient
 The student placed the patient on its rump
 The student placed the patient between their legs and allowed patient to relax
 The student kept control of the patient until the patient ceased to struggle
 The student slowly released the patient, allowed it to roll to its side and stand
 The student did not at any time grasp the patient by the wool
The Hercules Method
 The student grasped the head or neck with the hand under the jaw
 The student grasped the fold of the patient’s flank on the side furthest from them
 The student lifted and rolled the sheep onto their thighs
 The student lifted the feet of the patient off the ground
 The student set the patient on its rump
 The student placed the patient between their legs and allowed the patient to relax
 The student kept control of the patient until the patient ceased to struggle
 The student slowly released the patient, allowed it to roll to its side and stand up
 The student did not at any time grasp the patient by the wool

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor _________________________________________________

18
 Restrain Rat by Grasping Over Shoulders for Oral Exam / Injection

Date completed _______________________________

 The student isolated the rat without injury to either the animal or themselves
 The student restrained the rat to limit head movement so that the student is not injured, by one of
the following methods:
1. Placing the thumb on one side of the thorax just caudal to the scapula and the remaining
fingers on the opposite side of the thorax caudal to the scapula
2. Placing the thumb and forefinger on each scapula and pushing toward the ventral midline,
making the forelimbs cross under the animal’s chin
3. Placing the index finger on one side of the head cranial to the forelimb. The thumb and ring
finger are just caudal to the scapula, wrapping around the thorax
 The student provided support to the caudal half of the rat to control the animal and alleviate stress
while moving it to the examination table
 The student moved the rat from its cage to the table without losing control of the animal
 The student adequately controlled the rat when it struggled during the procedure
 The student determined the sex of the rat

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Handle Rat by Grasping the Base of the Tail

Date completed __________________________________

 The student isolated the rat without injury to the animal or personnel
 The student grasped the base of the tail
 The student lifted the rat from the cage and immediately placed it on the exam table before the
animal showed signs of stress
 The student moved the rat from its cage to the table without losing control of the animal
 The student successfully controlled the rat when it struggled

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administer Oral Drug / Medication to Rat

Date completed ________________________________

 The student correctly restrained the animal for the procedure

 The student measured and selected the appropriate oral gavage needle
 The student appropriately placed the oral gavage needle for injection of sterile saline while
monitoring the correct placement
 The student administered the sterile saline while monitoring the animal for signs of incorrect
placement
 The student was able to successfully control the animal when it struggled

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

19
 Administer Intraperitoneal Injection to Rat

Date completed __________________________________

 The animal was adequately restrained

 The animal was positioned with its head downward, on its back
 The student inserted the needle into the caudal abdomen
 The student aspirated with the syringe to check placement
 The student injected the medication

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administer Subcutaneous Injection to Rat

Date completed ______________________________

 The student selected the correct site for administration

 The student correctly restrained the animal for the injection
 The student properly introduced the needle into the site of administration
 The student aspirated the syringe to check for blood or air prior to injection
 The student successfully administered the prescribed volume of medication or saline

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Collect Blood from Rat

Date completed ____________________________

 The animal was correctly placed in sternal or lateral recumbency

 The student visualized the location of the vein being used for blood collection
 For tarsal/Saphenous venipuncture a digital tourniquet was applied to the leg (may be done by
assistant)
 The student placed the needle in the skin with the bevel facing up and in the proper location
 The student collected the blood either by using a microhematocrit tube in the hub of a needle or
removing the needle and using a microhematocrit tube directly at the puncture site
 Digital pressure was applied to prevent hematoma formation

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

20
 Restrain Rabbit in Towel with Head Exposed

Date completed ____________________________________

 The student properly positioned the rabbit on the towel

 The student wrapped the towel directly under the chin and around the thorax of the rabbit so the
forelimbs were secure
 The student was able to restrain the rabbit adequately when it struggled
 The student was able to restrain the rabbit in a manner that was adequate for the exam to be
performed yet did not harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Restrain Rabbit for Physical Exam and Sex Determination

Date completed ______________________________

 The student scruffed the rabbit while the ears were pressed against the shoulders and placed a
hand under the rump for support
 The student positioned the scruffed rabbit in dorsal recumbency so that the feet, legs and perianal
area could be examined
 The student restrained the rabbit in a manner that was adequate for control yet of no harm to the
animal
 The student immobilized the rabbit in a way that prevented personnel from being injured
 The student was able to restrain the animal adequately when it struggled
 The student determined the sex of the rabbit during restraint

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Restrain Rabbit in Cat Bag or commercial Rabbit Restrainer

Date completed ______________________________

 The student prepared the cat bag or rabbit restrainer

 The student scruffed the rabbit, supported the rump, and placed it into the cat bag or restrainer
 The student properly secured the cat bag or restrainer
 The student restrained the rabbit in a manner that was adequate for control, yet of no harm to the
animal
 The student immobilized the rabbit in a way that prevented personnel from being injured
 The student was able to restrain the animal adequately when it struggled

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

21
 Administer Subcutaneous Injection to a Rabbit

Date completed ______________________________

 The student selected the proper site for administration

 The student properly restrained the animal to immobilize and protect the animal from injuring itself
 The student palpated the area to determine the proper placement of the needle for administration
 The student applied negative pressure on the syringe to check for blood or air prior to injection
 The student successfully administered the prescribed amount of medication
 The student was able to restrain the animal when it struggled

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Collect Blood from a Rabbit

Date completed ______________________________

 The student properly restrained the rabbit to immobilize and protect the animal from injuring itself
during the procedure
 The student selected the proper site for blood collection
 The student clipped the fur from the ear if necessary
 The student placed the needle in the skin with the bevel facing up and in the proper location
 The student’s hand was in the proper position to hold the syringe and aspirate to obtain the sample
 The student placed a digit over the puncture site, removed the needle, and continued to apply
pressure to the site to prevent hematoma formation

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

22
 Restrain a Bird and Perform Physical Exam

Date completed _______________________________

 The student observed the bird to assess general appearance and condition before approaching it to
begin the physical exam
 The student removed water bowls, perches and food containers from the carrier, if applicable
 Room lights were dimmed to reduce stress on the bird, if applicable
 The student approached the bird in a non-threatening manner
 The student allowed the bird to see and interact with a towel before trying to place it over the bird
 The student placed the towel over the bird’s head
 The student appropriately grasped the bird firmly but gently around the neck while keeping the
towel over the bird’s head
 The student removed the towel from over the bird’s head and wrapped the remaining portion of the
towel around the body of the bird to prevent wing flapping, and thus potential injury to the bird or
restrainer
 The student effectively restrained the feet to prevent scratching of the restrainer
 The student was careful not to compress the thorax of the bird during restraint, avoiding
unnecessary distress and inadvertent suffocation of the bird
 The student examined the bird’s face, beak, and inside the mouth
 The student ausculted the heart and air sacs
 The student examined the cloaca for discharge
 The student accurately recorded findings
 The student submitted a written physical exam report

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Trim Nails on a Bird

Date completed _____________________________

 The bird was restrained appropriately either by the student or an assistant

 The student chose the correct type of nail trimmer
 The student placed the nail trimmers in the proper position on the nail
 The amount of nail removed was appropriate
 The nail did not bleed after removal of tip. If bleeding did occur, proper hemostasis was achieved by
applying pressure or a cauterizing agent

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

23
 Obtain a History – Small or Large Animal

Date completed ______________________________

 The student allowed the client to state the presenting problem before asking additional directed
questions
 The student asked the questions clearly and used terminology the client understood so that the
client was able to answer the question accurately
 The student maintained good communication skills:
-good eye contact
-non-verbal body language that encouraged the client to continue to speak
-allowed the client to finish a statement without interrupting
 The student asked questions in such a way that the question was not a leading
question (e.g. “you did see diarrhea, didn’t you?”)
 When/if a client was unable to understand a question the student was able to
formulate a different way of asking the same question and obtaining the needed
information
 The student periodically repeated the information back to the client to confirm what
the student heard was a correct interpretation of what the client said or meant
 The student was able to direct the history taking dialogue to obtain the information in
a timely manner (i.e., didn’t allow the conversation to wander too far from the goal of
getting a complete and accurate history
 The student was able to establish a working rapport with the client. The student
conducted the history interview in a courteous and professional manner
 The student was able to gauge the amount of history needed based upon the critical
status of the patient (i.e., if the case was an animal in critical status, only the
pertinent history was obtained before emergency treatment was begun)
 The student accurately recorded the history obtained from the client in sufficient
detail to convey all the information needed by the veterinarian

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Recording Patient Treatment/Clinical Data on a Hospitalized SA or LA Patient

Date completed _______________________________

 The student accurately identified the patient on the Hospitalization Record form
 The student accurately recorded the clinical status of the animal
 The student obtained and recorded an accurate TPR
 The student accurately recorded any treatments performed on the animal
 The student accurately recorded any medications administered to the animal
 The student accurately recorded the veterinarian’s orders for this patient
 The student accurately recorded any additional clinical data as directed by the veterinarian

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

24
 Participate in an Enema (Small or Large Animal)

Date completed ______________________________

 The appropriate volume of fluid to deliver was prepared

 A person wearing exam gloves, properly lubricated the tube
 The tube was passed into the animal’s rectum without force
 The prepared fluid was administered
 The tube was removed from the rectum
 The animal was placed in an area to observe the expulsion of contents from the colon

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform a Physical Examination on a Canine Patient

Dated completed ________________________________

 The student observed the patient to assess attitude before approaching the animal to begin
the physical examination
 The student examined each of the following items on the physical examination
 Temperature, pulse, respiration
 Capillary refill time
 General appearance
 Integumentary system
 Musculoskeletal system
 Circulatory system
 Respiratory system
 Genitourinary system
 Nervous system
 Ears
 Eyes
 Lymph nodes
 Mucous membranes

 The student accurately recorded the findings of the physical examination including any
abnormalities

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor _________________________________________________

25
 Perform a Physical Examination on a Feline Patient

Date completed __________________________________

 The student observed the patient to assess attitude before approaching the animal to begin
the physical examination
 The student examined each of the following items on the physical examination
 Temperature, pulse, respiration
 Capillary refill time
 General appearance
 Integumentary system
 Musculoskeletal system
 Circulatory system
 Respiratory system
 Genitourinary system
 Nervous system
 Ears
 Eyes
 Lymph nodes
 Mucous membranes

 The student accurately recorded the findings of the physical examination including any
abnormalities

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administer Oral Tablet or Capsule to a Dog

Date completed __________________________

 The student was able to open the mouth of the animal

 The student maintained control of the head or muzzle during the administration of the
medication
 The medication was swallowed without choking
 The student was able to control the animal in a manner that was adequate to administer the
medication yet did no harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

26
 Administer Oral Tablet or Capsule to a Cat

Date completed __________________________

 The student was able to open the mouth of the animal

 The student maintained control of the head or muzzle during the administration of the
medication
 The medication was swallowed without choking
 The student was able to control the animal in a manner that was adequate to administer the
medication yet did no harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administer Oral Liquid to a Dog or Cat

Date completed ____________________________

 The student maintained control of the head or muzzle during the administration of the
medication
 The medication was swallowed without choking
 The student was able to control the animal in a manner that was adequate to administer the
medication yet did no harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administer Eye Drops or Ointment to a Dog or Cat

Date completed ___________________________

 The student was able to open the eye of the animal

 The student maintained control of the head or muzzle during the administration of the
medication
 The student successfully administered the medication into the eye
 The medication was administered without contamination of the applicator tip
 The student was able to control the animal in a manner that was adequate to administer the
medication yet did no harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

27
 Administer Ear Medication to a Dog

Date completed _______________________

 The student was able to place the medication applicator in the proper position
 The student maintained control of the head or muzzle during the administration of the
medication
 The student successfully administered the medication into the ear canal
 The medication was administered without contamination of the applicator tip
 The student was able to control the dog in a manner that was adequate to administer the
medication yet did no harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administer Ear Medication to a Cat

Date completed _______________________

 The student was able to place the medication applicator in the proper position
 The student maintained control of the head or muzzle during the administration of the
medication
 The student successfully administered the medication into the ear canal
 The medication was administered without contamination of the applicator tip
 The student was able to control the cat in a manner that was adequate to administer the
medication yet did no harm to the animal

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administer Subcutaneous Injection to a Dog

Date completed __________________________

 The student selected the proper site for administration

 The student properly introduced the needle into the site for administration
 The student aspirated the syringe to check for blood or air prior to injection
 The student successfully administered the prescribed amount of medication

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

28
 Administer Subcutaneous Injection to a Cat

Date completed __________________________

 The student selected the proper site for administration

 The student properly introduced the needle into the site for administration
 The student aspirated the syringe to check for blood or air prior to injection
 The student successfully administered the prescribed amount of medication

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administer Intramuscular Injection to a Dog

Date completed __________________________

 The student selected the proper site for administration based on anatomical landmarks
 The student properly introduced the needle into the site of administration
 The student aspirated the syringe to check for blood prior to injection
 The student successfully administered the prescribed amount of medication

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administer Intramuscular Injection to a Cat

Date completed __________________________

 The student selected the proper site for administration based on anatomical landmarks
 The student properly introduced the needle into the site of administration
 The student aspirated the syringe to check for blood prior to injection
 The student successfully administered the prescribed amount of medication

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

29
 Perform Cephalic Venipuncture in a Dog

Date completed ____________________________

 The student selected the proper site for venipuncture

 The student properly introduced the needle into the site
 The student aspirated the syringe to check for blood
 The student drew the appropriate volume of blood for the required test
 The student or restrainer properly applied pressure to the puncture site to reduce bleeding

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform Cephalic Venipuncture in a Cat

Date completed ____________________________

 The student selected the proper site for venipuncture

 The student properly introduced the needle into the site
 The student aspirated the syringe to check for blood
 The student drew the appropriate volume of blood for the required test
 The student or restrainer properly applied pressure to the puncture site to reduce bleeding


Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform Saphenous Venipuncture in a Dog

Date completed ____________________________

 The student selected the proper site for venipuncture

 The student properly introduced the needle into the site
 The student aspirated the syringe to check for blood
 The student drew the appropriate volume of blood for the required test
 The student or restrainer properly applied pressure to the puncture site to reduce bleeding

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

30
 Perform Femoral/Medial Saphenous Venipuncture to a Cat

Date completed ____________________________

 The student selected the proper site for venipuncture

 The student properly introduced the needle into the site
 The student aspirated the syringe to check for blood
 The student drew the appropriate volume of blood for the required test
 The student or restrainer properly applied pressure to the puncture site to reduce bleeding

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administer Intravenous Cephalic Injection to a Dog

Date completed ____________________________

 The student selected the proper site for administration

 The student properly introduced the needle into the site of administration
 The student aspirated the syringe to check for blood prior to injection
 The student injected the drug without signs of extravasation
 The student or restrainer properly applied pressure to the puncture site to reduce bleeding

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administer Intravenous Saphenous Injection to a Dog

Date completed ____________________________

 The student selected the proper site for administration

 The student properly introduced the needle into the site of administration
 The student aspirated the syringe to check for blood prior to injection
 The student injected the drug without signs of extravasation
 The student or restrainer properly applied pressure to the puncture site to reduce bleeding

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

31
 Administer Intravenous Injection to a Cat

Date completed ____________________________

 The student selected the proper site for administration

 The student properly introduced the needle into the site of administration
 The student aspirated the syringe to check for blood prior to injection
 The student injected the drug without signs of extravasation
 The student or restrainer properly applied pressure to the puncture site to reduce bleeding

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Trim Toe Nails in a Dog

Date completed _____________________________

 The student placed the nail trimmers in the proper position on the nail
 The amount of nail tip removed was appropriate
 The nail did not bleed after removal of the tip

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Trim Toe Nails in a Cat

Date completed _____________________________

 The student placed the nail trimmers in the proper position on the nail
 The amount of nail tip removed was appropriate
 The nail did not bleed after removal of the tip

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

32
 Ear Sample Collection and Preparation in a Dog or Cat

Date completed _______________________________

 The student introduced the cotton-tipped applicator appropriately into the ear
 The swab, containing an appropriate sample, was removed from the ear and the sample
applied to either a culture medium, transport medium (for transport to an outside laboratory for
culture), or onto a slide (for examination for yeasts, parasites, and bacteria)
 The student stained the slide appropriately for yeast or bacteria
 The student applied mineral oil to the slide to look for otic parasites

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Clean Ears in a Dog

Date completed _____________________________

 The student appropriately administered cleaning solution to the ear canal in sufficient quantity
 The solution was administered without contamination of the applicator tip
 The student massaged the ear canal externally
 The student cleaned the outer ear with cotton balls
 The student avoided placing swabs into the ear canal
 The ear canal was clean after the cleaning process

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Clean Ears in a Cat

Date completed _____________________________

 The student appropriately administered cleaning solution to the ear canal in sufficient quantity
 The solution was administered without contamination of the applicator tip
 The student massaged the ear canal externally
 The student cleaned the outer ear with cotton balls
 The student avoided placing swabs into the ear canal
 The ear canal was clean after the cleaning process

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

33
 Express Anal Sacs in a Dog

Date completed _______________________________

 The student wore exam gloves

 The student located the position of the anal sacs
 The student lubricated the index finger
 The student appropriately positioned the finger internally and thumb externally to express the
anal sacs
 The contents of each anal sac were adequately expressed into a 4x4 gauze positioned
properly to prevent spraying or leakage
 The student cleaned the area after expressing the anal sacs

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Bathe a Patient - Dog or Cat

Date completed _______________________________

 Anal sacs were expressed and toe nail trims were done if required
 The student removed any collars or harnesses, cotton was placed in the ears
 The student thoroughly wetted the animal prior to application of the shampoo
 The student appropriately applied the shampoo and observed precautions
 The hair and skin were thoroughly rinsed of all shampoo
 Cotton balls were removed from the ears
 The animal was dried safely, adequately, and not overheated with a cage dryer
 Animal was combed or brushed, and mats removed if required

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Collect Free Catch Urine Sample –– Dog or Cat

Date completed ___________________________

 The student selected a clean container that was appropriate for the amount
 The student collected the urine after the initial stream
 The student avoided contaminating the collected urine by contact with the animal’s hair, etc
 The student collected at least 8 cc’s of urine from a dog (or 3 cc’s from a cat)

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

34
 Perform Jugular Venipuncture in a Dog
Date completed ___________________________

 The student correctly placed his/her finger in the jugular groove to act as a tourniquet
 The student palpated the area to determine the location of the jugular vein
 The student placed the needle in the skin with the bevel up and in the proper location
 The student student’s hand was in the proper position to hold the syringe and draw back on
the plunger to obtain the sample
 The student acquired the necessary volume for the tests ordered
 The student released the digital tourniquet when the appropriate volume was achieved
 The student placed a digit over the puncture site
 The needle and syringe were removed from the patient and digital pressure was continued to
prevent a hematoma
Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform Jugular Venipuncture in a Cat

Date completed _______________________________

 The student correctly placed his/her finger in the jugular groove to act as a tourniquet
 The student palpated the area to determine the location of the jugular vein
 The student placed the needle in the skin with the bevel up and in the proper location
 The student student’s hand was in the proper position to hold the syringe and draw back on
the plunger to obtain the sample
 The student acquired the necessary volume for the tests ordered
 The student released the digital tourniquet when the appropriate volume was achieved
 The student placed a digit over the puncture site
 The needle and syringe were removed from the patient and digital pressure was continued to
prevent a hematoma

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Place a Cephalic Catheter in a Dog

Date completed _____________________________

 The student clipped an area of appropriate size, leaving no hair at the site
 The student prepped the site for aseptic catheter placement and did not contaminate the site
 The student flushed the catheter with heparinized saline prior to placement
 The student placed the catheter into the skin with the bevel up
 The student looked for blood flow into the catheter and when blood was observed, threaded
the catheter off the stylet into the vein
 The student secured the catheter to the patient’s leg with tape without kinking the catheter
 The student flushed the catheter with heparinized saline

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

35
 Place a Cephalic Catheter in a Cat
Date completed ________________________________

 The student clipped an area of appropriate size, leaving no hair at the site
 The student prepped the site for aseptic catheter placement and did not contaminate the site
 The student flushed the catheter with heparinized saline prior to placement
 The student placed the catheter into the skin with the bevel up
 The student looked for blood flow into the catheter and when blood was observed threaded
the catheter off the stylet into the vein
 The student removed the stylet from the catheter and placed an injection cap on the catheter
 The student secured the catheter to the patient’s leg with tape without kinking the catheter
 The student flushed the catheter with heparinized saline

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Place a Saphenous Catheter in a Dog

Date completed _____________________________

 The student clipped an area of appropriate size leaving no hair at the site
 The student prepped the site for aseptic catheter placement and did not contaminate the site
 The student flushed the catheter with heparinized saline prior to placement
 The student placed the catheter into the skin with the bevel up
 The student looked for blood flow into the catheter and when blood flow as observed,
threaded the catheter off the stylet into the vein
 The student removed the stylet from the catheter and placed an injection cap on the catheter
 The student secured the catheter to the patient’s leg with tape without kinking the catheter
 The student flushed the catheter with heparinized saline

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Apply and Remove a Modified Robert Jones Bandage

Date completed _______________________________

 The student applied tape stirrups to the distal portion of the limb
 The student applied two layers of soft padding onto the limb starting at the distal portion of the
limb. The student made sure it was not too tight before starting the next layer
 The student applied a layer of gauze to the limb, starting at the distal portion of the limb. The
student made sure it was not too tight before starting the next layer
 The student reflected the tape stirrups to adhere to the gauze
 The student applied a layer of protective cover to the limb, making sure it was not too tight
 The limb was in proper position once the bandage was complete. The student checked the
toes for temperature and swelling
 The student appropriately removed the bandage from the patient

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

36
 Administer Subcutaneous Fluids to a Dog or Cat

Date completed ________________________

 The student chose the proper needle size for the patient
 The student placed the needle in the correct area
 The student administered the appropriate amount of fluids at each site

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform Cystocentesis in a Dog or a Cat

Date completed ______________________________

 The student palpated the bladder while the patient was restrained in lateral, dorsal or standing
recumbency
 The student chose the appropriate size needle for the patient and the appropriate size syringe
for the sample to be obtained
 The student examined the area of the needle placement to ensure its cleanliness and
prepared it with alcohol
 The student placed the needle on the midline (female)
 The student placed the needle in the correct area and avoided the prepuce (male)
 The student aspirated to determine if the needle was in the bladder. If the needle was in the
bladder, the student drew enough urine for the sample
 If the needle was not in the bladder, the student released negative pressure on the syringe,
withdrew the syringe and needle and got a new syringe and needle to try again. The student
did not redirect within the abdomen
 The student did not aspirate while placing or withdrawing the needle

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Place a Urinary Catheter in a Male Dog

Date completed _________________________

 The student chose the proper type and size catheter for the dog
 The student, while an assistant exposed the penis, prepared the penis aseptically without
touching the prepuce
 The student lubricated the distal end of the catheter without contaminating the catheter
 The student introduced and passed the catheter into the bladder without contamination
 The student emptied the bladder with a syringe if the catheter was to removed
 The student attached a collection system to the catheter if the catheter was to stay in

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

37
 Collect and Prepare Vaginal Cytology – Canine

Date completed ________________________

 The student had an assistant hold the dog in either sterna or standing recumbency
 The dog was held firmly to minimize movement prior to sampling
 The student properly placed a lubricated speculum into the vagina
 The student moistened a sterile cotton swab with sterile saline
 The student collected the sample as far cranial as possible without contaminating the
sample/swab
 The student rolled the swab across the slide to distribute the cells along the slide
 The student stained the slide with Diff-Quick

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Place a Stomach Tube in a Dog or Cat

Date completed _____________________________

 The student measured the tube, placing the tip of the tube at the last rib and marking the tube
at the point of the mouth prior to placement
 The student placed the mouth speculum in the mouth in the correct position
 The student properly lubricated the stomach tube
 The student properly passed the tube into the dog’s stomach without force
 The student verified the tube was in the stomach by palpating the tube within the neck,
injecting 100 mL of air and an assistant auscultating the stomach for gurgling, or injecting 50
mL of sterile saline and listening for a cough
 The student administered the medication into the stomach tube (Tap water may be used if
needed)
 The student sealed the end of the tube to prevent aspiration of medication and removed the
stomach tube from the dog

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

38
 Perform a Comprehensive Oral Health Assessment and Treatment in a Dog or Cat

Date completed ____________________________

 The student performed an oral exam to evaluate occlusion, any retained deciduous or
deformed teeth, and evaluate the amount of calculus present
 The student examined the gingival tissues and pocket depths around all of the teeth with a
periodontal probe and noted the abnormalities on either the dental or patient chart
 The student placed towels under the patient’s head and neck to prevent potential aspiration of
water and debris
 The student wore a mask, exam gloves and goggles before beginning the scaling of the teeth
 The student properly hand scaled the subgingival area of the teeth with a manual instrument
 The student removed the calculus from the supragingival area of the teeth, by either starting
out with manual instruments and then using the ultrasonic scaler, or just using the ultrasonic
scaler
 When manual instruments were used, the student maintained the proper angle with the
scaling instrument and moved from the gingival edge toward the crown
 The student did not leave the ultrasonic scaler on the tooth for longer than 10-15 seconds at a
time
 The student maintained the side of the ultrasonic scaler parallel to the tooth and worked with
overlapping strokes from the gingival edge toward the crown
 The student polished the teeth using the polish device at low speed, moving from each tooth
every 2-3 seconds
 The student rinsed the teeth with water to remove any residual debris from the mouth
 The student performed a post cleaning oral exam and charted the teeth on the appropriate
dental chart or record
 The student prepared a set of home care instructions for the client

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

39
 Perform Skin Scraping

Date completed ___________________________

 The student placed a drop of mineral oil on the microscope slides being used
 The student moistened the scalpel blade with mineral oil
 The student selected an appropriate site/lesion for scraping
 The student pinched a fold of skin and scraped the surface until drops of capillary blood
appeared
 The student transferred the material collected onto the glass slide with mineral oil

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform Visual Exam for External Parasites

Date completed ___________________________

 The student thoroughly inspected the animal from head to tail, looking for the presence of
external parasites
 The student parted the hair on the animal in several places in order to directly observe the
skin the evidence of external parasites or flea allergy dermatitis
 The student examined the ears for evidence of external parasites
 The student properly used a flea comb on the hair of the animal
 The student placed the material collected with the flea comb onto a moist white paper to
examine it for evidence of flea “dirt”

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Collect a Sample for Dermatophyte Culture and Inoculate Media

Date completed ___________________________

 The student identified a suspected Dermatophyte lesion

 The student cleansed the area with 70% alcohol on a cotton ball
 The student obtained a small scraping of superficial debris and hair from the margin of the
lesion using a sterile scalpel blade and forceps, or plucked a sample of hair from the margin of
the lesion using hemostats
 The student inoculated the culture media by placing the sample slightly below the surface of
the media
 The student left the lid to the tube slightly open
 The student allowed the culture to incubate at room temperature

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

40
 Perform Schirmer Tear Test

Date completed ___________________________

 The student prepared the test strip, folding at the notch while still in the package
 The student removed the strip from the package, touching only the end that is not placed on
the eye
 The student inserted the strip between the lower eyelid and the cornea
 The student held the strip in place for 60 seconds, preventing the animal from rubbing the eye
or removing the strip
 The student removed the strip from the eye and measured the length of the strip that was we
according to the manufacturer’s instructions

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform Fluorescein Stain Test

Date completed __________________________

 The student moistened the end of a sterile Fluorescein stain strip using sterile eye wash or
artificial tear solution
 The student elevated the upper eyelid
 The student placed the moistened tip of the strip on the bulbar conjunctiva for 1-2 seconds or
further moistened the strip and allowed the stain to drip onto the cornea
 The student removed the strip (if touched to the eye) and allowed the animal to blink
 The student flushed the eye with sterile eyewash
 The student examined the cornea in a partially darkened room

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform Tonometry

Date completed _____________________________

 The student checked the tonometer for function and cleanliness before using (calibrated)
 The student instilled topical ophthalmic anesthetic drops in both eyes without touching the tip
of the bottle to the eye
 The student waited 30-60 seconds before beginning the test
 The student assured the animal’s head was restrained and positioned for the procedure
 The student placed the tonometer on the animal’s cornea and noted the reading
 If a Schiotz was used, the student converted the values to mg Hg

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

41
 Application of Elizabethan Collar

Date completed _____________________________

 The student chose the correct size Elizabethan collar for the patient
 The student prepared/assembled the collar as needed
 The student applied the collar to the patient without causing injury or discomfort
 The student secured the collar so it could not be removed by the patient, but was not too tight
 Once placed, the collar prevented the patient from either chewing or scratching
inappropriately

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Apply Emergency Bandage / Splint (not a plain Modified Robert Jones)

Date completed ______________________________

 The student applied tape stirrups to the distal portion of the limb
 The student covered any open wounds with non-adhering gauze pads and secured them with
tape
 The student applied either roll cotton (Robert Jones bandage) or cast padding (splint) to the
limb, starting at the distal portion of the limb
 The student appropriately applied a layer of gauze to the limb, starting at the distal portion of
the limb
 If using a splint, the student chose an appropriate splint and applied it to the limb
 The student reflected the tape stirrups proximally on the limb
 The student applied a layer of protective tape such as Vetwrap® or Elastikon® to the limb
 The student checked the bandage after each layer to make sure it was not too tight
 The limb was in proper position once the bandage was complete
 The student checked the toes for temperature or swelling

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

42
 Hospitalized Patient Care, Recordkeeping and Observation of a Critical Patient

Date completed _____________________________

 The student chose and identified the patient by its signalment and ailment and recorded the
information on the patient record
 The student chose a critical case such as an unregulated diabetic, HBC, renal failure,
pancreatitis, etc.
 The student provided care for at least 4 hours of the patient’s hospitalization
 The student initialed each entry to verify they performed the observation and treatment during
the 4 hours
 The student recorded the hourly monitoring and observation parameters accurately and
chronologically
 The student recorded all treatments administered during the monitoring period accurately
 The student brought variations from normal parameters to the attention of the veterinarian in
charge of the patient
 The record was clear, accurate and easy to follow

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Calculate, Monitor and Maintain Intravenous Fluids and Provide IV Catheter Care

Date completed ___________________________

 The student chose a case which required intravenous fluids for a minimum of 12 hours
 The student showed their calculation of the flow rate for the IV fluids for the patient
 The student set the flow rate to deliver the desired amount
 The student recorded the volume of fluid administered hourly, as well as the total for the day
 The student maintained the correct rate of fluid administration
 The student monitored the IV catheter site for signs of swelling, redness or non-patency
 The student specifically observed the patient for parameters related to hydration status,
including respiration rate and character, lungs sounds, skin turgor, mucous membrane color
and character, and capillary refill time
 The student monitored the patient and recorded all data for at least 4 hours

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

43
 Closed-Chest Cardiopulmonary Resuscitation (CPR) – Small Animal

Date completed ____________________________

 The student simulated checking the patient for heartbeat and respiration
 The student simulated placing an appropriate size endotracheal tube, using a laryngoscope
and securing it with gauze
 The student simulated administration of oxygen using the proper delivery system and oxygen
flow rate
 The student simulated ventilation of the animal at the proper rate and pressure
 The student simulated performing chest compressions, using the proper technique for the
patient, at the proper rate
 The student demonstrated the technique for abdominal compressions/counterpulsions with an
assistant performing chest compressions
 The student simulated intravenous catheter placement and administration of fluids
 The student simulated the drawing and administration of emergency drugs as directed by the
veterinarian
 The student attached an ECG monitor to the patient

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform a Physical Examination in a Bovine Patient

Date completed ____________________________

 The student observed the patient to assess attitude before approaching the patient to begin
the physical examination
 The student counted the respiration rate of the patient by observing the nostril
movement/flares or chest movement for 30 seconds and recorded the number of respirations
in breaths per minute
 The student located and palpated an artery or ausculted the chest of the patient, counted for
15 seconds and recorded the heart rate results in beats per minute
 The student examined each of the following items on the physical examination:
 CRT/MM  Circulatory system
 General appearance  Respiratory system
 Body condition scoring  Genitourinary system
 Integumentary system  Nervous system
 Musculoskeletal system  Ear
 The student accurately recorded the findings of the physical examination including any
abnormalities

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

44
 Perform a Physical Examination in an Equine Patient

Date completed _____________________________

 The student observed the patient to assess attitude before approaching the patient to begin
the physical examination
 The student counted the respiration rate of the patient by observing the nostril
movement/flares or chest movement for 30 seconds and recorded the number of respirations
in breaths per minute
 The student located and palpated an artery or ausculted the chest of the patient, counted for
15 seconds and recorded the heart rate results in beats per minute
 The student examined each of the following items on the physical examination:
 CRT/MM  Circulatory system
 General appearance  Respiratory system
 Body condition scoring  Genitourinary system
 Integumentary system  Nervous system
 Musculoskeletal system  Ear
 The student accurately recorded the findings of the physical examination including any
abnormalities

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform Jugular Venipuncture in a Bovine Patient

Date completed _________________________________

 The student correctly placed his/her finger in the jugular groove to act as a tourniquet
 The student palpated the area to determine the location of the jugular vein
 The student wiped the area with alcohol, then placed the needle in the skin with the bevel up
and in the proper location, then attached the syringe
 The student’s hand was in the proper position to hold the syringe and draw back on the
plunger to obtain the sample
 The student released the digital tourniquet when the appropriate volume was achieved
 The student placed a digit over the puncture site
 The needle was removed from the patient; digital pressure was applied to prevent hematoma

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

45
 Administration of an Intravenous Injection in a Bovine Patient

Date completed _________________________________

 The student correctly placed his/her finger in the jugular groove to act as a tourniquet
 The student palpated the area to determine the location of the jugular vein
 The student wiped the area with alcohol, then placed the needle in the skin with the bevel up
and in the proper location, then attached the syringe
 The student’s hand was in the proper position to hold the syringe and draw back on the
plunger to check for blood prior to injection
 The student injected the drug without signs of extravasation
 The student placed a digit over the puncture site
 The needle was removed from the patient; digital pressure was applied to prevent hematoma

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administration of Subcutaneous Injection in a Bovine Patient

Date completed ______________________________

 The student selected the proper site for administration
 The student removed any debris from the injection site with alcohol or other appropriate
antiseptic
 The student properly introduced the needle into the site of administration
 The student aspirated the syringe to check for blood or air prior to injection
 The student successfully administered the prescribed amount of medication

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administration of Liquid Medication in a Bovine Patient

Date completed ______________________________

 The student was able to open the mouth of the patient
 The student maintained control of the head or muzzle during the administration of the
medication
 The student was able to insert the Frick (or equivalent) speculum and stomach tube or the
drenching instrument of choice
 The student passed the stomach tube and verified the correct placement
 The medication was swallowed without choking when using a drenching instrument
 The student was able to control the patient in a manner that was adequate to administer the
medication yet did not harm the patient
 The student removed the stomach tube so that the liquid remaining in the tube was not
aspirated by the patient
 The student removed the oral speculum that was used to facilitate the placement of the
stomach tube
Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

46
 Administration of Bolus Medication in a Bovine Patient

Date completed _________________________________

 The student restrained the head of the patient and was able to open the mouth of the patient
 The student maintained control of the head during the administration of the medication
 The student used the appropriate size balling gun for the patient
 The student inserted the balling gun in the patient’s mouth and over the tongue
 The medication was swallowed without choking
 The student was able to control the patient in a manner that was adequate to administer the
medication yet did not harm the patient
Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform Jugular Venipuncture in an Equine Patient

Date completed _________________________________

 The student correctly placed his/her finger in the jugular groove to act as a tourniquet
 The student palpated the area to determine the location of the jugular vein
 The student wiped the area with alcohol, then placed the needle in the skin with the bevel up
and in the proper location, then attached the syringe
 The student’s hand was in the proper position to hold the syringe and draw back on the
plunger to obtain the sample
 The student released the digital tourniquet when the appropriate volume was achieved
 The student placed a digit over the puncture site
 The needle was removed from the patient; digital pressure was applied to prevent hematoma

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administration of an Intravenous Injection in the Equine Patient

Date completed _________________________________

 The student correctly placed his/her finger in the jugular groove to act as a tourniquet
 The student palpated the area to determine the location of the jugular vein
 The student wiped the area with alcohol, then placed the needle in the skin with the bevel up
and in the proper location, then attached the syringe
 The student’s hand was in the proper position to hold the syringe and draw back on the
plunger to check for blood prior to injection
 The student injected the drug without signs of extravasation
 The student placed a digit over the puncture site
 The needle was removed from the patient; digital pressure was applied to prevent hematoma

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

47
 Administration of Intramuscular Injection in an Equine Patient

Date completed _________________________________

 In an adult horse, the student prepared the serratus cervicis for the IM injection, and
 pointed out and listed the anatomical borders of the site
 Without the needle attached to the syringe, while holding the hub of the needle between their
index and middle figure and the shaft of the needle toward their palm, the student tapped the
side with the back of their hand or fist and without hesitation, turned the needle toward the
neck and inserted it through the skin and deep into the muscle
 The student attached the syringe to the needle, aspirated, and injected 1 cc of saline
 There was no blood return on aspiration
 The student rubbed the site after withdrawal of the needle

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Administration of Liquid Medication in an Equine Patient

Date completed ______________________________

 The student was able to open the mouth of the patient

 The student maintained control of the head or muzzle during the administration of the
medication
 The student was able to insert the drenching instrument of choice
 The medication was swallowed without choking
 The student was able to control the patient in a manner that was adequate to administer the
medication yet did not harm the patient

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Collect Milk Sample and Perform California Mastitis Testing

Date completed __________________________________

 The student collected milk samples from each quarter in four clean CMT paddle cups labeled
A,B,C,D
 The student added an equal volume of CMT solution to each cup
 The student rotated the CMT paddle in a circular motion for 10 seconds to thoroughly mix the
contents
 The student read the test immediately and classified results based on the presence or lack of
thickening/gelling due to the presence/absence of DNA from white blood cells in the sample

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

48
 Lower Leg Wrap in the Horse

Date completed __________________________________

 The student properly approached the patient

 The student placed the padding on the lower limb (cannon) below the carpus on the forelimb
and below the hock on the hind limb and extending to approximately 1” distal to the coronet.
The leading edge of the padding was placed on the lateral surface of the cannon and
unwrapped, from the underside of the roll, caudally medial cranial and overlapped
laterally to finish. If roll cotton was used, at least two layers were applied with the leading end
of the bandage overlapped, approximately 2-3” with the end of the padding. The bandage was
unrolled from the top of the leading edge, moving caudally, medial, cranially, laterally, distally,
to just above the end of the padding at the hoof, then proximally, to just below the padding top
 The student applied the bandage without wrinkles, tight enough to prevent slippage but not so
tight as to restrict circulation

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Tail Wrap in the Horse

Date completed _____________________________

 The student properly approached the patient on the left side, properly moved to the patient’s
hind quarters, and stood to the side for the procedure
 The student removed debris or chaff from the tail
 The student unrolled approximately 12 inches of wrap, lifted the tail slightly, slid a single layer
under the tail, and moved it up toward the tail head as high as possible without wrinkling or
folding the wrap or rumpling the hairs. The wrap was positioned so it unrolled from the top of
the leading edge
 The student brought the leading edge of the wrap over the top of the tail and began to unroll
the wrap over the leading edge
 After two wraps at the top, the student continued distally, maintaining ever tension and
overlapping the wrap approximately half of the previous wrap
 Every 3-4 wraps, the student folded a tuft of hair into the wrap
 The student continued wrapping to a point 2-3 inches below the caudal vertebrae and secured
the wrap with the device appropriate for the wrap utilized

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

49
 Placement of Jugular Intravenous Catheter in a Large Animal

Date completed _______________________________

 The student clipped an area of appropriate size, leaving no hair at the site
 The student prepped the site for an aseptic catheter placement and did not
contaminate the site once it was prepped
 The student “tented” the skin and inserted the needle with the bevel up
 The student directed the needle into the vein and inserted the needle
 The student observed the catheter for blood flow and when blood was seen,
advanced the length of the catheter into the vein
 The student placed the needle guard over the needle
 The student removed any protective sleeve or stylet associated with the catheter
 The student placed an injection cap or extension set with cap on the catheter
 The student flushed the catheter with heparinized saline, aspirated blood to check
proper placement and patency, and flushed the catheter again
 The student secured the catheter with appropriate bandage material and technique

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Anesthesia Record Procedures – Large or Small Animal

Date completed _____________________________

 The anesthetic record included the following information

 Patient Name, Signalment, Weight
 Date
 Procedure
 Special precautions (if any) or patient conditions pertinent to anesthesia
 TPR prior to premedication and preferably at rest (that morning) or peri anesthetic
period, including the amount and the time it was given
 Heart rate, respiratory rate and gas concentration recorded every 5 minutes on the
anesthesia record
 IV fluid amount every 15-30 minutes (total at end of procedure)
 Blood pressure readings and pulse oximetry values recorded every 10 minutes (if
using)
 Notes pertaining to major anesthetic or surgical events
 Post operative pain medication (if given) agent and amount
 Time of beginning and end of anesthesia, procedure and extubation
 Synopsis of patient recovery
 The student used black or blue ink, no pencil
 The record was legible and able to be interpreted
 If a mistake was made, it was crossed out with a single line and initialed

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

50
 Anesthetic Delivery and Monitoring Equipment Use and Maintenance

Date completed ___________________________

 The student demonstrated/described use and maintenance of the following equipment:

 Pulse oximeter
 Esophageal stethoscope
 Electrocardiograph
 Rebreathing system
 Non-rebreathing system
 Induction chamber
 Blood pressure monitoring device
 Thermometer
 Scavenging system
 Oxygen source
 Laryngoscope
 Ambu bag
 Mask
 Capnometer

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Pre-Anesthetic Preparation of the Anesthetic Machine – Small Animal

Date completed ____________________________

 The student checked the oxygen source to verify there was enough oxygen to complete the
procedure if applicable
 The student turned the oxygen on and verified the oxygen pressure gauge was working and
the flow meter was functioning by turning on the flow meter temporarily to watch the ball move
to the desired oxygen flow
 The student checked the soda lime canister to ensure the granules were fresh according to
the practice standard operating procedure
 The student checked the vaporizer to make sure there was inhalant agent in the vaporizer and
that it was at least half full and the dial moved smoothly
 The student attached the proper breathing system and breathing bag for the patient being
anesthetized
 The student raced the flow from the source, to the patient, from the patient and back to the
scavenge system to ensure all connections were correctly assembled
 The student performed a low-pressure leak test to ensure all connections were secure and no
leaking of gas would occur
 The student opened the pop-off valve to ensure it was not stuck or closed prior to anesthesia

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

51
 Preparation of Supplies Prior to General Inhalant Anesthesia – Small Animal

Date completed _____________________________

 The student chose at least 2 endotracheal tubes of appropriate size for the patient to be
anesthetized, checked the cuffs for leaks, and placed them at the induction area
 If the case is a feline, the student prepared lidocaine spray/gel and a stylet to aid in intubation
 The student placed a piece of non-stretch gauze near the endotracheal tubes for use in tying
the tube. The piece was of adequate length to tie around the tube
 The student placed a syringe near the endotracheal tubes for use in filling the cuff after
intubation
 The student placed a syringe of heparinized saline at or near the induction site to use in
verifying intravenous catheter patency
 The student prepared an intravenous catheter of appropriate size for the patient being
anesthetized
 While leaving the catheter in the package, the student opened the catheter, removed the cap,
flushed the catheter with heparinized saline and placed at or near the induction area
 The student placed clippers and aseptic preparation materials at or near the induction are for
clipping and prepping the intravenous catheter site
 The student provided ophthalmic lubricating ointment at or near the induction are to lubricate
the eye after induction
 The student calculated oxygen flow rate prior to induction
 The student provided an oxygen mask near the induction area to provide oxygen or inhalant
agent prior to intubation if needed
 The student had a stethoscope and other monitoring devices (depending on practice standard
operating procedure) ready for use at the induction area and verified they were in working
order
 The student located and made others aware of the location of the emergency supplies in case
they are needed during the procedure
 The student provided towels, blankets and other methods for keeping the patient warm at the
area
 The student set up intravenous fluids with an administration set at the induction area for use
during anesthesia
 The student prepared the anesthesia record and placed it at the area for induction
 The student prepared the anesthesia induction agent so it was ready to administer at time of
induction

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

52
 Pre-Anesthetic Preparation of the Patient for Anesthesia – Small Animal

Date completed _____________________________

 The student identified the patient’s chart and reviewed it to ensure that the appropriate
laboratory tests had been performed as defined by the practice standard operating procedure
 The veterinarian was consulted regarding results prior to premedication or induction of general
anesthesia
 The student performed a physical exam prior to administering any anesthetic premedication
any abnormalities were brought to the attention of the veterinarian
 The student reviewed the procedure to be performed and the patient’s condition, and
prepared according to the facility SOP for premedication, general anesthesia and
maintenance
 The student calculated the dosages of preanesthetic agents and induction agents as
prescribed by the veterinarian, and had those doses checked by the mentor prior to
administration
 The student administered the approved premedications to the patient at least 15-30 minutes
prior to induction of general anesthesia

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Induction by Injectable Agent – Small Animal

Date completed _______________________________

 The student checked the syringe to verify the amount drawn up in the syringe matched the
calculations
 The student removed any air bubbles in the syringe
 The student flushed the patient’s catheter with heparinized saline to ensure its patency
 The student checked the work area one last time to make sure all materials were ready
 The student, with an assistant holding the patient, administered the induction agent according
to practice standard protocol
 The student attempted to open the patient’s mouth to determine if more induction agent was
needed to intubate

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

53
 Intubation of a Dog

Date completed ____________________________

 The student waited until the assistant opened the mouth and the dog did not resist opening of
the mouth
 The student chose an appropriate endotracheal tube, and used the tube to push the tongue
out to the side of the mouth so the assistant could grasp it with a gauze sponge and extend
the tongue over the lower canine teeth. The assistant or student did NOT place their hands in
the dog’s mouth at any time
 The student attached the breathing tubes, palpated at the thoracic inlet to feel the tip of the
endotracheal tube and to verify that only one tubular structure existed
 The student used roll gauze to secure the endotracheal tube
 The student inflated the cuff until no leak was heard when inflating the lungs to a pressure of
20 cm H2O a small leak should be heard when inflating the lungs past 20 cm H2O

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Intubation of a Cat

Date completed ___________________________

 The student waited until the assistant opened the mouth and the cat did not resist opening of
the mouth to apply lidocaine to the larynx
 The student chose an endotracheal tube, placed a stylet in the tube and used the tube to push
the tongue out to the side of the mouth so the assistant could grasp it with a gauze sponge
and extend the tongue over the lower canine teeth. The assistant or student did NOT place
their hands in the mouth at any time
 The student visualized the opening of the trachea, placed the tube in the trachea without
force, and pulled the stylet from the tube
 The assistant held the cat’s mouth shut and the cat was laid on its side while the student
attached the breathing tubes, palpated at the thoracic inlet to feel the tip of the endotracheal
tube and to verify that only one tubular structure existed
 The student used roll gauze to tie the endotracheal tube behind the cat’s head, and behind
both ears
 The student inflated the cuff until no leak was heard when inflating the lungs to a pressure of
20 cm H2O a small leak should be heard when inflating the lungs past 20 cm H2O

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

54
 Maintenance and Monitoring of General Anesthesia – Small Animal

Date completed ________________________

 The student set the oxygen flow rate according to the patient’s weight and requirement based
on the breathing system
 The student adjusted the vaporizer setting to 15-3% based on the patient’s response to the
induction agent
 The student verified that the patient was breathing and recorded a heart rate before
proceeding further to ensure the patient was stable following induction and intubation
 The student placed an esophageal stethoscope into the esophagus (if monitoring) order to
facilitate quick removal if an emergency arose
 The student attached the ECG (or appropriate alternative) according to the practice standard
operating procedure
 The student attached intravenous fluids to the catheter and set the rate for surgical
maintenance as ordered by the veterinarian
 The student manually squeezed the rebreathing bag every 1-2 minutes regardless of the
patient’s respiratory rate to 15-20 cm H2O
 The student recorded values including heart rate, respiratory rate, anesthetic gas
concentration and fluid volume administered (as well as any other parameters being
monitored) on the anesthesia record every 5 minutes (every 30 minutes for fluids)
 The student brought abnormal readings to the attention of the veterinarian
 The student checked the patient’s reflexes (palpebral, pedal, jaw tone, eye position,
depending on accessibility) to ensure the patient was neither too deep nor too light, and
brought abnormal responses to the attention of the veterinarian
 The student observed the patient’s respiratory function by observing the rebreathing bag to
count rate and observing chest excursions to ensure adequate depth of each breath
 The student maintained the anesthetic gas concentration at the lowest level possible to
achieve general anesthesia
 The student decreased the anesthetic concentration near the end of the procedure

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

55
 Recovery from General Anesthesia – Small Animal

Date completed _________________________

 The student turned off the inhalant anesthetic gas and administered oxygen for a period of 2-5
minutes to scavenge waste gases prior to disconnecting the breathing circuit
 The student inspected the oral cavity to insure it was free of secretions and/or objects that
could impede respiration
 The student maintained the patient’s head in a normal position
 The student deflated the endotracheal tube cuff and untied it from the patient to facilitate quick
removal
 If placed, the student removed the esophageal stethoscope and other monitoring devices prior
to the patient awakening from general anesthesia
 The student removed the endotracheal tube when the patient began to swallow (2-3 time)
without stimulation
 The student observed the patient following extubation for signs of respiratory distress and/or
cyanosis, and informed the veterinarian if abnormalities were noted
 If abnormalities were noted, the student administered oxygen while awaiting the arrival of the
veterinarian
 The student recorded heart rate, respiratory rate and temperature following extubation. Values
were recorded every 5 minutes for the first 15 minutes following extubation. Abnormalities
were brought to the attention of the veterinarian
 The student used available means to elevate body temperature to normal. The student
recorded the patient’s temperature every 30 minutes to insure the patient did not become
overheated. Heating methods were discontinued once the patient’s temperature reached 100
degrees Fahrenheit
 The student placed the patient (if recumbent) in the opposite recumbency as it was during the
procedure to assist in ventilating the previously “down” lung field
 If indicated, IV fluids were continued and the rate and catheter site monitored
 The patient was monitored for signs of pain and analgesics administered as needed on the
orders of a DVM, and recorded in the patient record
 The patient was monitored closely for respiratory depression if narcotic analgesic were
administered
 The student recorded recovery parameters and notes at the bottom of the anesthetic record to
become a part of patient’s permanent record

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

56
 Provide Post-Surgical Clean Up and Operating Room Sanitation and Care

Date completed ___________________________

 The student cleaned equipment and instruments used in a surgical procedure

 The student cleaned the surgery room following a surgical procedure
 The student properly disposed of hazardous medical waste
 The student properly sanitized the surgery room to prepare for the next surgery

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Clean Instruments Post-Operatively

Date completed __________________________

 The student selected at least five different types of instruments to clean

 The student opened instruments and disassembled multi-part instrument as appropriate
 The student mixed neutral pH instrument detergent with water
 The student placed soiled instruments in detergent solution
 The student scrubbed instruments with attention to:
 To-and-fro motion
 Direction of serrations
 Direction of metal grain
 The student avoided use of wire bristle brush
 The student used accessary cleaning tools as needed (i.e., pipe cleaner, bottle brush)
 The student rinsed the instruments thoroughly
 The student carefully inspected the instruments, removed instruments in need of repair, and
lubricated instruments with instrument milk
 The student re-assembled instruments if needed
 The student laid instruments out to dry or gathered instruments to prepare to assemble a pack

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Prepare a Surgical Pack for Sterilization

Date completed _____________________________

 The student gathered the appropriate instruments, and instrument plan if applicable
 The student gathered the appropriate linen supplies if applicable
 The student selected the appropriate packaging material and chemical indicator
 The student assembled the pack correctly by following the instructions on the checklist or
recipe
 The student appropriately selected and placed the chemical indicator
 The student appropriately selected and utilized packaging material

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

57
 Sterilize an Instrument Pack

Date completed ___________________________

 The student selected an appropriately prepared instrument pack

 The student placed the pack in a hi-vac or gravity autoclave
 The student stated verbally the type of steam autoclave: hi-vac or gravity
 The student stated verbally the steam autoclave settings for processing the surgical pack,
including temperature (degrees F or C), exposure time (minutes), and dry cycle time (minutes)
 The student operated the steam autoclave properly
 The student opened the autoclave door slightly for at least 10 minutes but not more than 20
minutes following processing was completed
 The student removed the surgical pack from the autoclave with attention to personal safety
and without compromising sterility (i.e., used oven mitt)
 The student placed the cooled pack on a clean, flat surface

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Sterilize an Individually Packaged Instrument or Item

Date completed________________________________

 The student selected appropriately prepared instrument or item, in a peel pouch or wrapped
Note: A package of 10-20 gauze squares would be considered an individual item
 The student placed the packaged item appropriately into the autoclave
 The student identified the type of steam autoclave: hi-vac or gravity
 The student identified the steam autoclave settings for processing the item, including
temperature (degrees F or C), exposure time (minutes), and dry cycle time (minutes)
 The student operated the steam autoclave properly
 The student opened the autoclave door slightly for at least 10 minutes but not more than 20
minutes following processing was complete
 The student removed the item from the autoclave with attention to personal safety and without
compromising sterility (i.e., used oven mitt)
 The student placed the cooled item on a clean, flat surface
 If item wrapped: The student opened the item to show that chemical indicators had changed
to indicate successful sterilization, stating verbally the changes noted
 If item in peel pouch: The student inspected the package to ensure it was intact, and stated
verbally the result of the inspection as well as the chemical indicator reading

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

58
 Open a Surgical Pack

Date completed ______________________________

 The student selected the appropriate surgical pack

 The area where the pack was placed was dry and level
 The pack is opened without contamination and the flaps are opened in the correct order
 The student checked the chemical indicator to ensure sterility

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Open a Gown and Gloves

Date completed _______________________________

 The student selected the appropriate gown size

 The student selected the appropriate glove size
 The area where the gown and gloves were placed was dry and level
 The gown is opened without contamination and the flaps are opened in the correct order
 The student checked the chemical indicator to ensure sterility
 The gloves are opened without contamination
 The student tied or assisted with tying the surgery gown aseptically

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Position Patient for Procedures and Express Urinary Bladder

Date completed ________________________________

 The student identified the procedure:

 Laparotomy
 Orthopedic procedure
 The student placed a heating pad and towels under the patient
 The student placed the animal in position and explains the reason for the position
 The student secured the limbs of the patient
 The student palpated the urinary bladder and expressed it as needed

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

59
 Participate in Ovariohysterectomy in a Dog

Date completed ______________________________

 The student observed the surgical procedure

 The student assisted the surgeon as needed
 The student participated in discussion related to the surgery as appropriate

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Participate in Ovariohysterectomy in a Cat

Date completed ______________________________

 The student observed the surgical procedure

 The student assisted the surgeon as needed
 The student participated in discussion related to the surgery as appropriate

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Participate in Orchiectomy in a Dog

Date completed ______________________________

 The student observed the surgical procedure

 The student assisted the surgeon as needed
 The student participated in discussion related to the surgery as appropriate

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Participate in Orchiectomy in a Cat

Date completed ______________________________

 The student observed the surgical procedure

 The student assisted the surgeon as needed
 The student participated in discussion related to the surgery as appropriate

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

60
 Clip and Prepare a Surgical Site

Date completed __________________________________

 The student defined the area to be clipped using the correct anatomical landmarks
 The student clipped all the hair from the surgical site according to the defined landmarks
 The student applied antiseptic scrub to the site
 The student prepped the site with a clean surgical sponge beginning at the incision site and
worked toward the edges
 The student discarded the sponge once it reached the edge of the clipped area
 The student did not bring the sponge back to the incision site once it was moved away from
the incision site
 The student wiped the site with a rinse solution using a clean surgical sponge following the
same pattern as when scrubbing with the antiseptic
 The student repeated the scrub and rinse a minimum of 3 times or until the final rinse sponge
was clean

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Scrubbing of Arms and Hands for Surgery

Date completed ________________________________

 The student identified the brush as a disposable brush or a clean re-sterilized brush
 The student applied the antiseptic scrub over both arms and hands
 The student began scrubbing the first hand and arm beginning at the fingertips
 The student scrubbed ends of the fingers 10 times
 The student scrubbed each of the four surfaces of each finger 10 times
 The student scrubbed each of the four sides of the hand 10 times
 The student scrubbed each of the four sides of the arm 10 times
 The student repeated the same process on the second hand and arm
 The student repeated the procedure on both hands and arms one more time
 The whole procedure lasted a minimum of 5-7 minutes
 The student did not touch any non-sterile objects
 The student kept their hands above the elbows at all times during and after the scrub

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

61
 Aseptically Don Surgical Gown

Date completed ____________________________________

 The student picked up the towel from the opened sterile gown without contamination or
dropping the hands below the elbows
 The student dried the first hand beginning at the fingers and working toward the elbow
 The student discarded the towel without contamination
 The student removed the sterile gown from the wrap and shook it out without contamination
 The student placed both arms in the sleeves and worked the gown on without contamination
 The hands of the student did not exit the sleeves of the gown
 The student stood with arms at chest while the shoulders and back of gown are tied by
another person

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform Closed Gloving Technique as a Scrub Nurse

Date completed ______________________________________

 The student picked up the first glove from the open package and placed it thumb toward the
palm and fingers pointing towards the elbows
 The student grasped the glove on both sides through the sleeves of the gown and stretched
the glove to create an opening
 The student pulled the glove over the hand
 The student moved their fingers from inside the cuff to the glove
 The student placed their fingers into the fingers of the glove
 The student pulled the sleeve of the gown and adjusted the glove to fit
 The student repeated the process with the other glove and hand
 The student made final adjustments on the gloves so that they fit snugly on the hands
 The student did not contaminate the gloves or gown while putting the gloves on their hands

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

62
 Aseptically Pass Instruments as Scrub Nurse

Date completed ______________________________

Scalpel blade and handle

 The student passed the blade with the left hand to a right handed surgeon
 The sharp edge of the blade was pointed away from the student’s hand
 The blade was visible at all times by the student and the surgeon
 The handle was placed firmly into the surgeon’s hand
 The surgeon was able to use the instrument with minimal adjustment
 When the instrument was returned to the student, it was wiped clean of blood and replaced on
the organized table

Towel clamp

 The student held the towel clamp so that when it was passed to the surgeon, it was used with
minimal adjustment
 The student “snapped” the instrument into the hand of the surgeon
 When the instrument was returned to the student, it was wiped clean of blood and replaced on
the organized table

Needle holder

 The student loaded the needle and suture on the needle holder such that when it was passed
to the surgeon, the needle is pointed at the surgeon
 The student “snapped” the instrument into the hand of the surgeon
 The surgeon was able to use the instrument with minimal adjustment

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Provide Aseptic Surgical Assistance with Care of Exposed Tissues

Date completed _________________________

 The student utilized appropriate instrumentation for the tissue handled

 The student kept tissue moist and protected
 The student maintained aseptic technique

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

63
 Aseptically Pass Instruments as Circulating Nurse

Date completed ____________________________

Surgery Pack

 The student placed the surgery pack on a clean, dry surface

 The student removed or tore the tape holding securing the pack
 The student opened the pack without contamination and the flaps are opened in the correct
order
 The student stepped away so the surgeon or scrub nurse could complete the opening of the
pack

Steri-peel Instrument

 The student detached the corners of the steri-peel without contamination or accidentally
opening it too much
 The student peeled back the edges of the steri-peel
 The student did not roll their wrists
 The student stopped when the instrument was exposed enough for the surgeon or scrub
nurse to grasp
 The student allowed the surgeon or scrub nurse to control the removal of the instrument
 The instrument was not contaminated during the opening process

Cloth or Paper Wrapped Instrument

 The student removed or tore the tape securing the pack

 The student opened the flaps in the correct order
 The student grasped the flaps with the hand holding the instrument so that contamination of
the surgeon or scrub nurse did not occur
 The student stopped when the instrument was exposed enough for the surgeon or scrub
nurse to grasp
 The student allowed the surgeon or scrub nurse to control the removal of the instrument
 The instrument was not contaminated during the opening process

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Operate and Maintain Suction and Cautery Machines

Date completed _________________________

 The student correctly demonstrated set up of a suction machine and described/performed use
and cleaning
 The student correctly demonstrated set up of a cautery machine and described/performed use
and cleaning

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

64
 Removal of Sutures

Date completed ____________________________

 The student clearly visualized and inspected the incision site

 If there were problems with the incision site, the student informed the veterinarian
 If there were no problems with the incision, the student removed the sutures
 The student used the correct tool to remove the sutures
 The student did not cause unnecessary harm or discomfort to the patient

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Complete Controlled Substance Log

Date completed _____________________________

 The student accurately recorded all information for dispensing a controlled substance, in a
real or simulated log

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Medication Labeling

Date completed _________________________________

 The student accurately transcribed the veterinarian’s order (written)

 The appropriate label for the medication to be dispensed was used
 The handwritten or typed label was legible
 The instructions were clearly stated for the client or personnel using the medication
 The label contained the following information: veterinarian’s address, name of client, species,
name of the patient, amount to be administered, dosage interval for the medication, special
instructions for the medication, and the name of the prescribing veterinarian

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

65
 Filling an Oral Solid Medication

Date completed ______________________________

 The student accurately transcribed the veterinarian’s order onto the appropriate label as defined in
the medication labeling task
 The student chose the correct medication (type, concentration and milligram) to fill the order
 The student used the correct tools, as provided by the practice, to count out the medication
 The student did not handle the medication with their hands
 The student counted out the correct account as defined in the veterinarian’s order
 The student placed the oral solid medication into the proper container for dispensing

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Filling a Liquid Medication

Date completed ______________________________

 The student accurately transcribed the veterinarian’s order onto the appropriate label as defined in
the medication labeling task
 The student chose the correct medication (type and concentration) to fill the order
 The student used the correct tools, as provided by the practice, to measure out the proper amount
of medication
 The student chose the correct container to hold the volume of medication needed for dispensing
 The student measured the correct amount for dispensing as defined in the veterinarians order
 The student identified the device needed to administer the liquid medication

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Reconstitute a Medication for Dispensing

Date completed _________________________________

 The student accurately transcribed the veterinarian’s order onto the appropriate label as defined in
the medication labeling task
 The student chose the correct medication (type and concentration) as ordered by the veterinarian
 The student chose the correct device to measure out the diluents to be added to the medication
 The student chose the correct diluents, as defined by the manufacturer’s instructions
 The student followed the manufacturer’s instructions in regards to adding the diluents and
preparation for dispensing
 If not provided with the medication, the student identified the device needed to administer the liquid
medication
 The student identified, on the label, instructions for shaking and refrigeration if indicated by the
veterinarian or manufacturer

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

66
 Reconstitute a Vaccine

Date completed _________________________________

 The student chose the proper vaccine as specified by the veterinarian

 The student chose the correct diluents as specified by the vaccine manufacturer
 The student chose the correct device to withdraw the diluents from the vial
 The student wiped off the top of the vials with an alcohol sponge
 The student followed the manufacturer’s instructions in regards to adding the diluents to the
powdered vaccine preparation
 The student gave the reconstituted vaccine to the veterinarian to be administered

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Dispense Medication to the Client

Date completed __________________________________

 The student accurately verbalized the veterinarian’s order to the client

 The student asked the client if they have ever given this type of medication to their pet before
 The student demonstrated to the client how to administer the medication
 The student demonstrated to the client how to use the administration device where indicated
 The student identified possible adverse reactions the client should be aware of and what the
client should do if they occur
 The student asked the client if they had any questions

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

67
 Assist in / Perform Prosection on Non-Preserved Animal

Date completed ______________________________

______ The student checked and recorded signalment for patient

______ The student reviewed the patient history, clinical diagnosis, and laboratory data
if available
______ The student examined and recorded the patient’s external appearance,
including
 body condition  hair coat
 mucous membranes  parasites
 body orifices  lips, gums, cheeks and
 general conformation teeth
 superficial lesions
(tumors, dermatitis, etc)

~Note: External examination should be done with the DVM present, or the DVM should examine the
animal before proceeding

______ The student placed the animal in lateral or dorsal recumbency and identified species
______ The student correctly identified the following structures during the prosection:
 Exposed superficial  Aorta
lymph nodes  Vena cava
(mandibular, popliteal,  Omentum
superficial cervical)  Spleen
 Jugular veins  Pancreas
 Mammary glands or  Liver
testes  Gall bladder
 Prepuce and penis  Kidneys
(male animal)  Adrenal gland
 Diaphragm  Ureters
 Pericardial sac  Urinary bladder
 Mandible  Stomach
 Tongue  Pyloric region
 Larynx  Duodenum
 Tonsils  Jejunum
 Esophagus  Ileum
 Trachea  Cecum
 Bronchi  Colon
 Lungs  Rectum
 Pulmonary vessels  Mesentery
 Heart

______ The student correctly identified the components of the pluck

______ The student correctly identified the four main organs that are routinely examined
and sampled
______ The student simulated collection of samples for submission for bacteriology, molecular, and
virology labs, including cutting correct size samples and labeling
______The student accurately documented all observations made by the DVM

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

68
 Collection, Preservation and Shipping of Samples

Date completed ______________________________

______ The student correctly identified when tissues may be pooled in the same jar
______ The student examined the liver, lung, and spleen grossly and collected samples
of lesions and adjacent normal tissue, 1 cm thick and 1 cm x 1 cm square. If the
liver was grossly normal, the student collected a representative sample (1 x 1 x
1 cm)
______ The student examined the kidneys grossly and collected samples of lesions and
adjacent normal tissue in longitudinal wedge sections 1 cm thick. If the kidneys
were grossly normal, the student collected a representative sample (1
longitudinal wedge)
______ The student examined the intestines grossly and discussed special handling of intestinal
samples.
______ The student placed the tissue samples into formalin if indicated
______ The student labeled each sample tissue packet with the following information:
1. Client name or clinician name
2. Animal species
3. Lab that is to test the tissue
4. Date of collection of fresh tissue
5. Site of collection (e.g., liver, right kidney)

______ The student correctly identified the submission forms to use for samples
collected
______ The student learned basic shipping procedures of sending diagnostic samples
______ The student identified all the levels of items (5) needed to ship samples
correctly
______ The student demonstrated the ability to use the ADDL website
______ The student correctly identified two reasons that cause delay of testing
samples
______ The student correctly identified requirements for submission of samples to the
Animal Disease Diagnostic Laboratory

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

69
 Packed Cell Volume

Date completed ___________________________

 The student mixed by 8-10 gentle inversions a properly collected, anticoagulated (EDTA) tube
of fresh whole blood
 The student filled a plain capillary tube 2/3 to ¾ full, wiped the outside of the tube with a
laboratory tissue, and sealed the end of the tube with sealing clay
 The student placed the capillary tube in a slot in a microhematocrit centrifuge, sealed end to
the outside edge, and noted the slot number
 The student balanced the centrifuge with a balance tube or another patient tube
 The student secured the centrifuge lids and covers
 The student set the appropriate centrifugation time (and speed where applicable)
 After the centrifuge stopped spinning, the student removed the tube and recorded the
presence of hemolysis, lipemia, or icterus
 The student obtained results by one of the following methods:

Determining the packed cell volume with a card reader

 Using a card reader the student aligned the bottom of the red cell column with the zero
percent (0%) line and the top of the plasma with the 100% line
 The student read the packed cell volume at the top of the packed red cell column and
recorded the value as a percentage
 The instructor verified the test result (within 2% of actual)

Determining the packed cell volume with a circle reader

 The student made all observations and alignments of the capillary tube by viewing from
directly above the reader
 The student placed the capillary tube in the groove of the plastic indicator so the intersection
of the clay sealant and the packed red blood cells lined up with the black line, located close to
the center post of the reader
 The student rotated the lower metal plate so the 100% line is directly beneath the red line on
the plastic indicator
 Keeping the lower metal plate in the same position and using the finger hole in the upper
plate, the student rotated the upper plate so the black spiral line lined up at the top of the top
of the plasma column
 The student rotated both the upper and lower plates until the black spiral line lined up at the
top of the red cell column
 The student read the packed cell volume from the scale directly beneath the red line on the
plastic indicator and recorded the result as a percentage
 The instructor verified the test result (within 2% of actual)

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

70
 Total Protein

Date completed ____________________________

 The student checked the zero setting and cleanliness of the refractometer
 The student mixed by 8-10 gentle inversions, a properly collected, anticoagulated (EDTA)
tube of fresh whole blood
 The student filled a plain capillary tube 2/3 to ¾ full, wiped the outside of the tube with a
laboratory tissue, and sealed the end of the tube with sealing clay
 The student placed the capillary tube in a slot in a microhematocrit centrifuge sealed end to
the outside edge, and noted the slot number
 The student balanced the centrifuge with a balance tube or another patient tube
 The student secured the centrifuge lids and covers
 The student set the appropriate centrifugation time (and speed where applicable)
 After the centrifuge stopped spinning, the student removed the tube and recorded the
presence of hemolysis, lipemia, or icterus
 The student broke the hematocrit tube above the buffy coat
 Holding the refractometer horizontally, with the cover plate in position on the prism, the
student placed a drop of plasma adjacent to the cover plate, insuring there was no
contamination from the buffy coat, other cellular components, or glass shards. The student
may have enhanced plasma flow by tapping the end of the tube close to the cover plate
 The student held the refractometer to their eye with the prism toward the light focused when
necessary, read the total protein value where the dark and bright area intersect and form a
line on the scale, and properly recorded the result
 The instructor verified the test result
 The student cleaned the measuring prism and cover plate with water and dried them with
laboratory tissue

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

71
 Blood Film Preparation

Date completed ____________________________

 The student properly mixed, by 8-10 gentle inversions, a properly collected, anti-coagulated
(EDTA) tube of fresh whole blood
 The student filled a capillary tube with blood, and from the tube placed a drop of blood, by
touching the capillary tube to the microscope slide, approximately one (1) cm from the frosted
end of the slide
 For the handheld method, the student held the microscope slide between their thumb and
index finger with the frosted end toward the index finger
 For the table top method, the student held the microscope slide on the outer corner of the
frosted end of the slide, with the frosted end toward their body
 While holding the spreader slide at approximately a 30-45 degree angle, the student brought
the spreader slide back into the drop of blood. The blood was allowed to spread along the
edge of the spreader slide, which was then moved forward in an even, forward motion
 The student produced a film approximately one-half to two-thirds the length of the slide (~1” in
length)
 The student’s blood film was slightly narrower then the width of the slide
 The feathered edge of the student’s blood film was relatedly straight across to slightly curved,
and did not end abruptly or have tail-like extensions
 When viewed macroscopically, the student’s blood film appeared to have a gradual transition
from the thicker body of the film to the feathered edge
 The student’s blood film did not have any lines, holes, scratches, streaks, extensions, or
ridges
 The student allowed the blood film to air dry
 The student stained the blood film with a rapid stain by initially dipping the blood film for
approximately ten (10) one (1) second dips in the fixative and subsequently making
approximately ten (10) one (1) second dips in Solution One (“eosin”) and Solution Two
(“Methylene blue”)
 The student rinsed the back side of the slide with water
 The student allowed the blood film to air dry
 The student labeled the blood film on the frosted end of the slide with patient ID, species and
date

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

72
 Differential

Date completed _____________________________

 The student placed the stained slide on the microscope stage

 The student scanned the blood film under low power (10X) with the light, condenser, and iris
properly adjusted and evaluated the quality of the blood film (acceptable body, monolayer,
and feathered edge) and reported the presence off microfilaria, platelet clumps, or any other
abnormalities
 The student applied immersion oil to the film and rotated the objective to the oil immersion
objective (100X), readjusted the light, iris and condense, and identified the monolayer for
counting
 The student classified and counted 100 white blood cells
 The student identified, quantified, and reported any red blood cell, white blood cell or platelet
abnormalities seen
 The student performed a platelet estimate in the monolayer of the blood film
 The student reported:
 The number of each type of WBC as a percentage
 Cellular morphology
 Platelet estimate
 The instructor verified the test results (WBC percent’s within 10% of actual, platelet estimate
within 20% of actual, correct identification of key morphologic elements

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Modified Manual CBC

Date completed _______________________________

 The student performed a manual white blood cell Unopette® following established laboratory
protocol and properly reported the test results
 The student performed a total protein and packed cell volume using established laboratory
protocol, and properly reported the test results
 The student performed a differential using a properly stained, quality blood film, including
count and classification of 100 white blood cells, evaluation of RBC, WBC and platelet
morphology and a platelet estimate, and properly reported the results
 The student accurately calculated and reported the white blood cell absolute values
 The student accurately calculated and reported the mean corpuscular volume (MCV)
 The instructor verified the test results
 WBC count within 10% of actual
 TP within .2g/dl of actual
 PVC within 5% of actual
 WBC differential percentages within 10% of actual
 Platelet estimate within 20% of actual

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

73
 Automated CBC

Date completed ______________________________

 The student followed the laboratory protocol for the performance of an in-house automated
CBC
 The student properly reported the results, including proper units of measurement
 The student completed an evaluation of a blood film including evaluation of cellular
morphology, check of the distribution of types of white blood cells, and noted any
discrepancies between the blood film and reported results
 The instructor verified the test results

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Coagulation Test

Date completed ______________________________

 The student followed an established protocol for the performance of two different in-house
coagulation tests
 The student accurately reported the results, including the proper units of measurement
 The instructor verified the test results
 Fibrinogen within 200mg/dl of actual
 Platelet counts within 20% of actual

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Prepare Serum and Plasma

Date completed ______________________________

 The student allowed the serum tubes to adequately clot prior to centrifugation
 The student “rimmed” the serum clot tubes prior to centrifugation
 The student centrifuged the tubes according to the centrifuge manufacturers
recommendations for speed and time
 The student harvested the serum and plasma with a disposable pipette, delivering it into plain,
clean labeled tubes
 The condition of the serum or plasma was reported if abnormal (hemolysis, lipemia, or icterus)

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

74
 Chemistry Panel

Date completed ____________________________

 The student followed the manufacturer’s established protocol for the performance of an in-
house chemistry panel
 The student accurately reported the results, including proper units of measurement
 The instructor verified the accuracy of the student’s results

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Collect and Crossmatch Blood for Transfusion

Date completed ____________________________

 The student demonstrated and described the proper care of the patient, collection,
processing, and evaluation for one crossmatch procedure
 The student accurately reported crossmatch results using proper medical terminology and
units of measurement

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Urinalysis

Date completed ____________________________

 The student properly performed the physical observation of the urine sample (color, turbidity,
specific gravity with a refractometer), reported the results, including proper terminology and
units of measurement
 The student properly performed the chemical analysis of the urine using commercially
available dipstick, and reported the results, including the proper units of measurement
 The student prepared (mixed, centrifuged, decanted, applied the sample to a glass slide, etc)
a urine sediment sample then correctly identified and quantified the elements contained in the
urine sediment
 The instructor verified the accuracy of the student’s result

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

75
 Serology

Date completed ____________________________

 The student followed the manufacturer’s established protocol for the performance of in-house
serology tests (ELISA, slide/card agglutination)
 The student accurately reported the results, including proper units of measurement
 The instructor verified the accuracy of the student’s result

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Streak Agar Plate to Obtain a Pure Culture

Date completed _______________________________

 The student used an inoculating loop to collect a sample of bacteria from an isolated colony.
The plate from the previous task may be used
 The student used an inoculating loop to apply the primary streak on a blood agar plate
 The student rotated the plate and used an inoculating loop to streak the second quadrant of
the blood agar, being careful to overlap the primary streak 1-2 times
 The student rotated the plate and used an inoculating loop to streak the third quadrant of the
blood agar, being careful to overlap the second streak 1-2 times
 The student inverted the agar plate and placed it in an incubator for 18-24 hours
 The student checked the plate after the incubation period for isolated colonies of growth

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Sample for Culture and Inoculation of Broth

Date completed __________________________

 The student removed the cap of the broth tube with the last two fingers
 The student dipped the inoculating needle into the sample
 The student stirred the needle in the broth
 The student replaced the cap on the tube, labeled the tube, and placed it into the incubator

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

76
 Prepare a Gram-stained Slide

Date Completed ______________________

 The student selected a bacterial sample by touching a sterile wire or loop to one colony on an
agar plate (did not scoop an entire colony off the agar plate)
 The student mixed the sample on a microscope slide with a drop of water or saline
 The student circled the sample droplet on the slide with a wax pencil to help identify the area
after staining
 The student allowed the slide to air dry
 The student heat fixed the slide by passing it through a flame 2-3 times, specimen side up
 The student held the slide over the sink or placed it on a rack over the sink, flooded the
smear with crystal violet, and let stand for one minute
 The student rinsed the smear briefly with water
 The student held the slide over the sink and flooded the smear with Gram’s iodine solution
and let stand for one minute
 The student rinsed the smear briefly with water
 The student washed the smear with decolorizer until no more purple color washed off (5-10
seconds)
 The student rinsed the smear briefly with water
 The student held the slide over the sink and flooded the smear with safranin and let stand for
one minute
 The student allowed the slide to air dry or gently blotted it dry between paper towels
 The student mounted the slide on the microscope and focused on the smear beginning with
the low power lens and working up to the oil immersion lens, and verbally stated Gram
Reaction and morphology

Supervisor Name _______________________________ RVT / DVM

Signature of Supervisor ____________________________________

Perform a Catalase Test

Date Completed ________________________

 The student selected a bacterial sample by touching a sterile loop or wire to the center of one
colony on an agar plate. If a blood agar plate was used, the student avoided contacting the
agar with the loop or wire
 The student applied a drop of 3% hydrogen peroxide onto a microscope slide
 The student smeared the sample in the drop of hydrogen peroxide
 The student immediately observed the slide for bubbling. If using a loop, the student
observed the loop for bubbling as well
 The student showed the slide and verbally identified whether the sample was catalase
positive or negative

Supervisor Name _______________________________ RVT / DVM

Signature of Supervisor ____________________________________

77
 Perform an Oxidase Test

Date Completed _________________________

 The student placed a drop of oxidase reagent onto a sterile swab

 The student touched the moistened swab to an isolated colony on an agar plate
 The student waited 30-60 seconds for a color change on the swab
 The student showed the swab and verbally identified whether the sample was oxidase
positive or negative

Supervisor Name _______________________________ RVT / DVM

Signature of Supervisor ____________________________________

Perform Kirby-Bauer Disc Sensitivity Test

Date completed _____________________________

 The student selected 4-5 morphologically identical colonies from a blood agar or MacConkey plate and
aseptically transferred the selected colonies to a tube of sterile saline with an inoculating loop
 The student mixed the contents of the tube by swirling (not inverting) the tube so that the organisms
were uniformly suspended in the saline
 The student compared their tube with .5 McFarland nephelometer to ensure that the turbidity in the
tubes was the same
 The student adjusted the turbidity in their tube as needed, by dilution or adding of colonies, to attain a
suspension of bacteria with a turbidity equal to the .5 McFarland nephelometer
 The student used aseptic technique to dip a sterile cotton swab into the saline suspension of bacteria
 The student rotated the swab against the inner wall of the tube to express excess fluid
 The student swabbed the entire surface of a Mueller-Hinton agar plate with the swab
 The student rotated the plate 60° and re-swabbed the entire surface
 The student again rotated the plate 60° and re-swabbed the entire surface, then ran the swab around
the outside edge of the agar
 The student applied the antibiotic discs with flamed forceps that were allowed to cool between uses.
The student gently pressed each disc on the agar surface to ensure complete contact, and made sure
the discs were at least 24 mm apart from center to center. The student also ensured that the discs did
not move once contact with the agar surface was made
 The student allowed the plate to sit for 1-2 minutes, then inverted the plate and placed it into an
incubator
 The student removed the plate from the incubator after 16-18 hours
 The student measured the cleared zone diameters in mm
 The student recorded the measurements
 The student consulted the lab table to determine the susceptibility character of the organism

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

78
 Perform and Read Direct Fecal Smear

Date completed _______________________

 The student placed a drop of saline on a microscope slide

 The student added a tiny amount of feces to the slide
 The student thoroughly mixed the feces and saline with an applicator stick or toothpick to form
a homogenous emulsion
 The student made a smear on the slide that was sufficiently thin to see newspaper print
through
 The student placed a coverslip over the smear
 The student placed the slide on a microscope and examined the area of the slide under the
coverslip at 10X power, and noted and recorded any parasitic material found in the sample

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform and Read Fecal Flotation

Date completed __________________________

 The student selected about ¼ teaspoon of feces and placed it in a vial

 The student added enough flotation solution to fill the vial about half full
 The student mixed the feces into solution with an applicator stick (or equivalent) until no large
fecal particles remained
 The student filled the vial with more solution until there was a visible meniscus at the top
 The student placed a cover slip on top of the vial
 The student allowed the vial to sit undisturbed for 10-15 minutes
 The student carefully removed the cover slip without tilting it and placed it on a microscope
slide
 The student placed the slide on a microscope and examined the area of the slide under the
coverslip, and noted and recorded any parasitic material found

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

79
 Perform by Centrifugation and Read Fecal Flotation

Date completed ___________________________

 The student selected about ¼ teaspoon of feces and placed it in a fecal cup
 The student added enough flotation solution to fill the vial about half full
 The student mixed the feces into solution with an applicator stick (or equivalent) until no large
fecal particles remained
 The student poured the mixture through cheesecloth into a 15 ml centrifuge tube
 The student filled the tube with solution until there was a visible meniscus at the top
 The student placed a cover slip on top of the vial
 The student placed the tube in the centrifuge and spun the mixture for 3-5 minutes at 1300-
1500 rpm
 The student carefully removed the cover slip without tilting it and placed it on a microscope
slide
 The student placed the slide on a microscope and examined the area of the slide under the
coverslip, and noted and recorded any parasitic material found

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Perform and Read Fecal Sedimentation

Date completed ______________________________

 The student placed about 1 teaspoon of feces into a paper cup

 The student added saline or water to the cup
 The student thoroughly mixed the feces into the solution
 The student poured the mixture through cheesecloth into a 15 ml centrifuge tube (the tube
should be about ½ full)
 The student placed the tube in the centrifuge and spun the mixture for 3-5 minutes at 1300-
1500 rpm
 The student slowly poured the liquid from the tube without disturbing the sediment layer on the
bottom
 The student used a pipette to transfer a small amount of the fine sediment to a microscope
slide
 The student placed a cover slip over the sediment on the slide
 The student placed the slide on the microscope, examined the area of the slide under the
cover slip, and noted and recorded any parasitic material found

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

80
 Perform Heartworm Diagnostic Tests

 The student performed heartworm diagnostic testing according to the clinic SOP for
heartworm testing

 The student performed a direct smear and correctly interpreted the result

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Date completed ____________________________

 The student performed an antigen test and correctly interpreted the result

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Date completed ____________________________

 The student performed a Knott’s test and correctly interpreted the result

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Date completed ____________________________

81
 Radiography Safety Procedures

Date completed __________________________

 The student followed standard safety procedures

 The student properly used protective lead gown, gloves and thyroid shield

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Complete Radiology Log

Date completed _____________________________

 The student accurately recorded all information for radiographs produced on patients, in a real
or simulated log

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Participate in Contrast Study

Date completed ____________________________

 The student participated in a radiographic contrast study (GI series, pneumocystogram,

intravenous urogram, etc.)

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

82
 Lateral Thoracic Radiograph
*Note: Small animal thorax and abdomen radiographs must collectively include canine and feline patients
– one case must be a cat, and the other must be a dog. Both views (abdomen or thorax) should be done
on the same case.

Date completed ___________________________ Species: Canine Feline (Circle)

 The student positioned the animal in right lateral recumbency
 If multiple sizes of cassettes are available, the student selected a size cassette appropriate for the
size of the animal to be radiographed
 If multiple sizes are not available, the student appropriately collimated the primary beam to include
only the landmarks for thoracic radiographs as defined in the textbook
 The student extended the front limbs cranially so that the elbow was not superimposed over the
thoracic cavity on the radiograph
 The student had the head and neck in a natural position such that the neck was neither extended
nor flexed
 The student had the animal positioned so that the sternum and dorsal spinous processes were in a
plane parallel to the table (the animal was not rotated)
 The student made the radiograph at peak inspiration
 The student made the radiograph such that the image included the manubrium as the cranial
landmark, and halfway between xiphoid and last rib as the caudal landmark. The image should
include the entire lung field from the sternum to the thoracic spinal column
 The student used the correct exposure technique to visualize the bronchial vasculature
 No part of the lead glove or positioned appears on the radiograph

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Ventrodorsal Thoracic Radiograph

*Note: Small animal thorax and abdomen radiographs must collectively include canine and feline patients
– one case must be a cat, and the other must be a dog. Both views (abdomen or thorax) should be done
on the same case.

Date completed ___________________________ Species: Canine Feline (Circle)

 The student positioned the animal in a ventrodorsal position

 If multiple sizes of cassettes are available, the student selected a size cassette appropriate for the
size of the animal to be radiographed. If multiple sizes are not available, the student appropriately
collimated the primary beam to include only the landmarks for thoracic radiographs as defined in
the textbook
 The student extended the front limbs cranially so that the forelimbs are not obstructing the thorax
and the lead gloves are out of the primary beam and not visible in the radiograph
 The student had the animal positioned so that the sternum and dorsal spinous processes were
superimposed in a plane perpendicular to the table (the animal was not rotated)
 The student made the radiograph at peak inspiration
 The student made the radiograph such that the image included the manubrium as the cranial
landmark, and halfway between xiphoid and last rib as the caudal landmark. The image should
include the entire lung field
 The student used the correct exposure technique to visualize the bronchial vasculature
 No part of the lead glove or positioner appears on the radiograph

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

83
 Lateral Abdominal Radiograph

*Note: Small animal thorax and abdomen radiographs must collectively include canine and feline patients
– one case must be a cat, and the other must be a dog. Both views (abdomen or thorax) should be done
on the same case.

Date completed _____________________________ Species: Canine Feline (Circle)

 The student positioned the animal in right lateral recumbency

 If multiple sizes of cassettes are available, the student selected a size cassette appropriate for the
size of the animal to be radiographed
 If multiple sizes are not available, the student appropriately collimated the primary beam to include
only the landmarks for abdominal radiographs as defined in the textbook
 The student extended the rear limbs caudally so that the femur was not superimposed over the
caudal abdominal cavity on the radiograph
 The student had the animal positioned so that the sternum and dorsal spinous processes were in a
plane parallel to the table, and the wings of the ilium were superimposed (animal was not rotated)
 The student made the radiograph at expiration
 The student made the radiograph such that the image included the three rib spaces cranial to the
xiphoid as the cranial landmark, and greater trochanter as the caudal landmark. The image should
include the entire abdomen
 The student used the standard operating procedure exposure technique to visualize the soft tissue
contrast
 No part of the lead glove or positioner appears on the radiograph

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor ____________________________________________

Ventrodorsal Abdominal Radiograph

*Note: Small animal thorax and abdomen radiographs must collectively include canine and feline patients
– one case must be a cat, and the other must be a dog. Both views (abdomen or thorax) should be done
on the same case.

Date completed ______________________________Species: Canine Feline (Circle)

 The student positioned the animal in a ventrodorsal position

 If multiple sizes of cassettes are available, the student selected a size cassette appropriate for the
size of the animal to be radiographed
 If multiple sizes are not available, the student appropriately collimated the primary beam to include
only the landmarks for abdominal radiographs as defined in the textbook
 The student extended the rear limbs caudally so that the rear limbs were not obstructing the
abdomen, and the lead gloves were out of the primary beam and not visible in the radiograph
 The student had the animal positioned so that the sternum and dorsal spinous processes were
superimposed in a plane perpendicular to the table (the animal was not rotated)
 The student made the radiograph during expiration
 The student made the radiograph such that the image included the three rib spaces cranial to the
xiphoid as the cranial landmark, and greater trochanter as the caudal landmark. The image should
include the entire abdomen
 The student used the standard operating procedure exposure technique to visualize the soft tissue
contrast
 No part of the lead glove or positioner appears on the radiograph

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

84
 Ventrodorsal Extended Pelvis Radiograph (OFA View)

Date completed _______________________________

 The student followed standard radiographic safety procedures as defined in the textbook
 The student selected a size of cassette appropriate for the pelvis to be radiographed and
appropriately collimated the primary beam to include only the landmarks for the ventrodorsal
pelvis as defined in the textbook
 The student selected a detail (slow speed) cassette, or made adjustments for rapid speed
cassettes
 The student positioned the animal in dorsal recumbency with the front limbs extended and
secured cranially and the rear limbs extended and secured caudally
 The student positioned the animal such that the patella was perpendicular to the x-ray beam
and centered in the trochlear groove and then secured the stifles to maintain this position
 The student ensured the rear limbs were parallel to the x-ray table, equally extended and as
close to the table as possible to prevent increased object film distance and/or foreshortening
 The student positioned the pelvis such that the pelvic girdle was not angled in relation to the
femurs
 The student placed a lead R or L marker next to the corresponding lateral side of the pelvis
 The student positioned the animal such that the x-ray beam would be centered between the
coxofemoral joints at the level of the pubic symphysis
 The student collimated the primary beam to include the wings of the ilium and the stifle joints
 The student placed the calipers at the highest point of the area to be radiographed
 The student accurately interpreted the caliper measurement according to manufacturer’s
instructions
 If a grid was available, the student placed the cassette in the cassette tray directly beneath the
x-ray table
 If no grid was available the student placed the cassette directly on top of the x-ray table, just
beneath the pelvis and adjusted the technique
 The student selected the exposure factors according to the previously developed technique
chart for producing a diagnostic radiograph
 The student produced the radiograph such that the collimated image included the correctly
chosen limb marker and the landmarks for the ventrodorsal extended pelvic view
 No part of the lead glove appeared on the radiograph

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Create Diagnostic Intra-Oral Dental Radiographic Images

Date completed ____________________________

 The student positioned the patient correctly for dental radiographs

 Using dental radiographic equipment, the student produced diagnostic intra-oral dental
radiographic images
 The student followed standard radiographic safety procedures

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

85
 Lateromedial Projection of the Metacarpophalangeal (Fetlock)

Date completed _____________________________

 The student selected a size cassette appropriate for the anatomic region to be radiographed, or
collimated to include only landmarks
 The student selected a detail cassette
 The student positioned the animal squarely so that the weight was evenly distributed on each limb
 The student placed the cassette against the medial aspect of the Metacarpophalangeal (fetlock)
 The student positioned the primary beam parallel to the floor at appropriate focal film distance, and
centered on the meddle of the metacarpophalangeal (fetlock) joint
 The student selected a RF, LF, RR, or LR limb marker according to which limb was being imaged,
and placed the marker just cranial to the metacarpophalangeal (fetlock) joint
 The student selected the exposure factors according to the previously developed technique chart
 The student produced the radiograph with proper collimation such that only the landmarks for the
entire metacarpophalangeal (fetlock) joint and the marker were included
 The student used a portable x-ray machine to produce this image.

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

Dorsopalmar Projection of the Metacarpophalangeal or Dorsoplantar Projection of the

Metatarsophalangeal (Fetlock)

Date completed _________________________________

 The student selected a size cassette appropriate for the anatomic region to be radiographed, or
collimated to include only landmarks
 The student selected a detail cassette
 The student positioned the animal squarely so that the weight was evenly distributed on each limb
 The student placed the cassette against the plantar or palmar aspect of the metatarsophalangeal
or metacarpophalangeal (fetlock)
 The student angled the primary beam 20 degrees proximal to distal, at appropriate focal film
distance and centered on the midsaggital plane of the metatarsophalangeal or
metacarpophalangeal (fetlock) joint
 The student selected a RF, LF, RR or LR limb marker according to which limb was being imaged,
and placed the marker just lateral to the metatarsophalangeal or metacarpophalangeal (fetlock)
joint of interest
 The student selected the exposure factor according to the previously developed technique chart
 The student produced the radiograph with proper collimation such that only the landmarks for the
entire metatarsophalangeal or metacarpophalangeal (fetlock) joint and the correct marker were
included

Supervisor Name ______________________________________________ RVT/DVM

Signature of Supervisor __________________________________________________

86
Student Name _____________________________________________________

Notes

87
Student Name _____________________________________________________

Notes

88
Student Name _____________________________________________________

Notes

89
Student Name _____________________________________________________

Notes

90