Repeat after me: Practice makes perfect—perfection doesn't happen by accident. It happens through training. Excellence in veterinary practice revolves around training programs for all employees, from support staff to the high-ranking specialists.
In the world of human medicine, at places like the Mayo Clinic, fellows accompany clinicians on rounds. They learn their craft at the feet of the more skilled. Apprentice training is wonderful, and in practices where it's in place, it produces excellent results. But apprentice-type training has largely vanished from the veterinary arena.
In addition to apprentice training, mentorship is beneficial for both parties involved. The profession would benefit from its further deployment within the private practice setting, but seldom do we see it as a formal part of our lives these days as the short-term economic pressures override long-term training. While we do see expanding short-term internship or residency programs in veterinary medicine, these are pretty much available on a limited basis and at a significant cost to the trainee.
For excellence in the clinical world, training must become a lifelong obsession, and therefore it must be a major part of a veterinary practice. With training, we can better understand the world we work in. The better we understand options regarding customer service and the various ways to address medical issues, the better we're able to pass this on to consumers—who then will respond intelligently.
So without further ado, here are the 15 ingredients of an effective training program:
The astute practice leader nurtures skill development by pairing up staff to permit a mentor/mentee relationship. For example, pair senior technicians with junior staff members and senior clinicians with new graduates.
This is essential to all training endeavors. Employees need repetition in order to assure consistency day-to-day, year-to-year, and staff member to staff member. Because of limited in-house resources, there's a tendency to limit training because of the financial and time commitment needed in order to train folks. So set up a budget to assure you have the dedicated resources and time to make team training a priority.
3 In-house and outside training
Local, state and national CE meetings like CVC in Washington, D.C., offer a wide variety of opportunities for exposure to updated ideas and concepts. But the most important training is what takes place on a daily basis within your practice.
Once employees are trained, what they remember and implement tends to undergo a metamorphosis. This drifting is an issue you'll need to address. Monitor employees' duties day-to-day to ensure that the training, compliance and consistency remain steady and don't morph into something you don't recognize.
5 Written format
Training works best when the duties are in written format. Create templates cookbook style—step by step.
The challenge is: Do you focus training on operational issues or quality of medicine issues? Focus too much on one and the other slides. If you focus too much on operations, including fees, clients can be put off. If you focus too much on medicine, you wake up three years down the road and wonder why your practice's cash flow is poor. Making money is easy. Being good is hard. Effective training determines excellence in a practice. Excellence leads to prosperity.
7 Increase value
If you want a raise, make yourself more valuable to those signing the paycheck. To be more valuable, seek to expand the value to the practice by assimilating the duties on the training list and develop new skills with creative training.
If you have a training budget, it'll let everyone in your practice know the importance of training. Practices can set a budget of 1 percent to 3 percent of the gross revenue for training purposes.
A holier-than-thou attitude stands in the way of training. Call it arrogance or narcissism, but effective training begins when we acknowledge that we don't know what we don't know. Add this to the concept that we probably have forgotten more than we remember and there becomes a whole nest of things that can be the focus of training.
10 Teach to learn
Teaching is the best way to learn, so have trained staff members teach the newcomers. And have the newcomers repeat the task back to the instructing staff members.
11 Education station
An education station (read more about it at dvm360.com/educationstation ) serves as a useful tool to keep these issues top of mind. A library of CDs, videos, books, handouts and templates will serve your practice well.
A theme of the month helps keep minds active. Plan each year to have 12 monthly themes or issues to focus on.
13 Training/retraining list
As soon as your team has learned a new skill or topic, make sure that this duty goes onto a retraining list. Most assuredly as soon as your team learns a new duty, it undergoes individual interpretation and morphs into a modified duty. Identify clarify/verify and training/retraining items. Using daily worksheets, ask staff what they need to revisit.
14 Phases of a career
It's been said that one's professional career can be divided into three phases: 1) learn all you can, 2) earn all you can, 3) lead (teach) all you can. Each phase can take 10 years. With the profession's current emphasis on production pay and the necessity to retire student debt the "learn all you can" phase gets shortened. With the shortened learning phase, burnout sets in earlier, because in our profession learning is the fountain of youth.
15 List of 100
Make a list of issues for which training is essential. A beginning list for a practice might have 100 items. Like blocks in a wall, the list of 100 are basic duties to more complex duties, helping the practice acquire more skills and expand its array of services. There are six essential steps for each item on the list of 100. They are:
> Visual introduction: Provide a quick view of the project.
> Reading: Provide templates, pictures and videos of the project to be reviewed.
> Hand-to-hand demo: Provide a working demonstration of the project.
> Flying solo with supervision: Provide the trainee the opportunity to go solo with supervision.
> Allow independence: Provide the opportunity for the trainee to work without supervision.
> Repeat 1, 10, 100 or 1,000 times: Provide the trainee the chance to perform the duty repeatedly. By the time he or she reaches 1,000 repetitions, he or she should be proficient.
Dr. Riegger, dipl. ABVP, is the chief medical officer at Northwest Animal Clinic Hospital and Specialty Practice. Contact him by telephone or fax (505) 898-0407, Riegger@aol.com 
, or www.northwestanimalclinic.com . Find him on AVMA's NOAH as the practice management moderator. Order his books Management for Results and More Management for Results by calling (505) 898-1491.