VETERINARY PROFESSIONAL CERTIFICATION PROGRAM

Slide 1
Welcome to Module 4: The Fear Free Exam Room

Slide 2
Interactive slide. Contains no audio.

Slide 3
This module has 5 lessons:
Lesson 1: Preparing the Exam Room
Lesson 2: History Taking for a Fear Free Physical Examination Lesson 3: Client Communication
Lesson 4: Patient Interaction Lesson 5: Physical Examination

Slide 4
Using Fear Free techniques, you can ensure a Fear Free experience for clients, patients, and the
veterinary team.

Slide 5
A Fear Free exam room relies on creating a calm environment where patients can participate in
examinations and minor procedures without experiencing FAS. Being sensitive to the way
patients sense and perceive their environment helps practices select the proper equipment,
supplies, and products to create the Fear Free exam room. In addition, this knowledge will help
the team provide an exam with as little FAS as possible for the patient.

Slide 6
Lesson 1: Preparing the Exam Room

Slide 7
By the end of this lesson, you will be able to:
• Understand how patients experience the exam room
• Create your own Fear Free exam room
• Apply the benefits of a Fear Free exam room in your practice

Slide 8
Patients experience the sensory environment differently than you do. Take a moment and
imagine the exam room from the patient’s perspective. What do they hear? What do they see?
What do they smell? What kinds of touch do they receive? Stimuli that the patient can hear,
smell, taste, see, or touch can cause FAS. The social environment can also be stressful.
Consider the impact to the patient of familiar people, unfamiliar people, and other animals.
Any stimuli in the environment may cause FAS.

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Slide 9
The examination room should feel as safe as possible for your patients. Keep noise to a
minimum. When possible, choose a quiet exam room, use white noise to drown out stressful
auditory stimuli, speak in calming tones, and use calming music to help soothe the patient.
Odors from other animals should be minimized by cleaning the room well between patients and
avoiding using strong smelling chemicals or air fresheners.

Patients should be protected from having to interact with strangers other than necessary team
members in the exam room. Keep the entry and exit of team members to a minimum.
Pheromones should be used to help calm the patient.

Reducing the amount of sensory stimuli can make relaxation easier, decreasing FAS.

Slide 10
The environment should be set up to provide comfortable and safe working surfaces for the
exam. Using non- slip mats to provide good traction in combination with a soft bed or towel can
help both cats and dogs feel more comfortable in the room. Infant changing table pads work
well for cats, as they have elevated sides and a soft padded surface. Any items used should be
easy to clean.

Work on the floor, on the table, in the patient’s carrier, in your lap or the owner’s lap, depending
on the
individual preferences of the animal. Cats should be provided with an area to hide, should they
wish to do so.

Enter the patient’s preferences in their emotional record so that they can easily be duplicated at
the next visit and all thereafter.

Slide 11
This picture shows an ideal feline exam room. Moving from left to right: table with non-slip mat,
baby scale so that the patient doesn’t have to be moved to be weighed, reward ladder of food
litterbox, bowl of water, cat toy, cat tree, and a pheromone diffuser.

Slide 12
Many of your patients like to hide in the exam room, hiding gives them a sense of security.
Provide hiding spaces so that they don’t hide behind the owner or in spots where removing them
would be stressful or provoke aggression. Instead, provide constructive opportunities for hiding
which facilitate examination.

Acceptable hiding spaces include: the bottom of a carrier, a designated elevated hiding cubby,
pheromone-infused, warm towels placed over and/or under the patient, or sitting on the owner’s
lap.

Slide 13

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These pictures demonstrate 2 options for hiding. While the patient in these pictures is a cat, any
patient in a carrier can hide in this way. By letting the patient hide in the carrier, FAS is reduced,
without reducing the team’s ability to access the patient when needed.

Slide 14
These pictures demonstrate less than ideal hiding spots for patients. The cat on the left is
hiding under a table. Note the defensive body language signs such as paws tucked under the
body and tail curled around the body.
The cat on the right is hiding under a chair. Both of these hiding spots will make picking up the
patient for a physical examination more stressful than if they were in the carrier hiding.

Slide 15
The exam room should be stocked with plenty of readily available treats and toys as different
patients will view different things as rewarding or distracting. This will allow you to create a
ladder of rewards for each patient to help diminish FAS. Keep treats of different flavors,
textures, and sizes in each exam room. Make a note in the record of each patient’s preference
to help the team prepare for the next visit. For procedures that may be particularly
uncomfortable, (temperature measurement or administering vaccinations) use food or toys
before, during, and after the procedure. Encourage clients to bring their pet’s favorite treats from
home as well, especially those with dietary restrictions.

Some treats will require a plate, spoon, tongue depressor, pretzel rod, syringe, or other tool to be
used to provide the food.

Some patients also enjoy playing with toys in the exam room, which helps them to relax and
enjoy the visit.

Slide 16
Patients are sensitive to changes in environment, and it takes time for them to adjust and
become comfortable in a strange place. Keeping everything you might need for a basic exam in
the room helps decrease changes in environment, which can cause avoidable stress and
anxiety. Anticipate which procedures will be performed whenever possible for the patient, by
consulting the medical record and the veterinarian.

Make sure items such as otoscopes, ophthalmoscopes, eye testing materials, tools to measure
blood pressure, materials to collect blood and urine, and any necessary immunizations are at
hand. Allowing the patient to remain in the exam room for these basic procedures helps
decrease fear and stress by reducing the number of environmental changes the patient must
tolerate.

In the event additional handling materials such as towels, anxiety-reducing wraps, a muzzle, or
other protective gear is needed, it is a good idea to keep a supply of each available in each exam
room. Veterinary team members working in the exam room should review the record to ensure
that the patient’s preferences and any additional tools such as muzzles are readily available
before the appointment starts.

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Slide 17
Interactive slide. Contains no audio.

Slide 18
Interactive slide. Contains no audio.

Slide 19
Your patients are sensitive to the sights, sounds, and scents of the veterinary hospital. Any
stimulus in the hospital can increase FAS. By preparing the examination room before the patient
arrives FAS can be diminished.

Slide 20
Lesson 2: History Taking for a Fear Free Physical Examination

Slide 21
To facilitate a Fear Free examination, it is essential to obtain an emotional history as well as the
medical history for the patient.

Slide 22
By the end of this lesson, you will be able to:
• Obtain and record the emotional history of the patient.
• List the reasons that recording the patient’s emotional history is of importance.
• Describe how to note the emotional history in the medical record.

Slide 23
When setting up an appointment for a patient, the client care representative (CCR), as discussed
in module 3, should gather an emotional history of how much FAS the patient has experienced
at earlier visits. When the patient arrives at the veterinary hospital, both an emotional and
medical history should be obtained and assessed in the exam room. This allows for a specific
assessment of the patient's needs at this time. Equally important is to review the record to
determine FAS the patient has shown at previous veterinary visits. From that information, the
veterinary health care team can determine the priority of needs for care and create a handling
plan for the current visit. When all the information is known beforehand, a handling plan can
also be outlined prior to the visit to positively condition the patient to the veterinary hospital.

Slide 24
A complete history includes an emotional and medical history to facilitate the best care
possible for the patient.
Ask the client about the animal’s FAS level in the veterinary hospital at this time. Observe and
record signs noted of current FAS. Veterinary team members should report FAS status to the
veterinarian. Together they can prioritize patient needs versus wants with consideration of the
patient’s FAS at this moment. Veterinary team members should record an emotional and
medical history in the medical record for this examination to use for future reference at
subsequent visits.

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Slide 25
To best prepare for a Fear Free visit, review the medical and emotional record before entering
the examination room. Avoid known triggers when possible. Once in the room note signs of
patient FAS, the stimuli to which the animal is reacting, and the location. Record descriptive
observations in the emotional record (tail down, ears back) that indicate FAS.
Alert team members to the triggers to FAS so every veterinary team member can provide a Fear
Free visit if possible.

Slide 26
Before you begin any examination or procedure, it is necessary to create a ranking of rewards to
indicate the most favored reward for the patient you are working with. Each patient will have
their own preferences for distractions and rewards. Some will prefer toys and some will prefer
food. Others may prefer petting or brushing. In general, hard crunchy treats are lowest value and
soft treats and foods to smear onto pretzels or spoons tend to be the highest value. Once the
patient’s preferences are determined, they should be entered into the emotional record.

Lower levels of observed FAS may allow the use of lower value rewards. In order to properly
assess the patient’s preferences, use the 2 refusal rule. If the patient refuses a particular food,
reward, or distractor twice, move up to the next rung of the ladder and try a different food
reward. It is best to devise a way to score the patient’s preferences quickly so that the next visit
is easy to prepare for.

Slide 27
These pictures show examples of the types of foods and treats to use for a reward ladder.

Slide 28
If the patient shows signs of stress or resistance, stop the procedure and reassess the
situation.

If after increasing the treat value and moving the patient to a more comfortable location the
patient is still anxious, consider rescheduling the appointment for another day. If the procedure
must be done on that particular day, the goal should be to make the procedure as pleasant as
possible. When working with patients it is helpful to perceive it as a two-way conversation. The
patient will respond to your communication with

species-specific communication including vocalizations and body language signs. It is

Slide 29
Struggling is a sign of fear and an attempt to escape the situation, not disobedience or
dominance. The essence of Gentle Control is to minimize struggling. If a canine patient
struggles longer than 3 seconds or a feline patient struggles for longer than 2 seconds, this
indicates the need to stop and either reposition, reassess the handling technique, or reassess
the overall handling plan.

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Implement a 3 tries rule for dogs and a 2 tries rule for cats. Allowing animals to have bad
experiences in the hospital advances their fear, increasing the likelihood of a negative
conditioned emotional response and can make handling more and more difficult each time.
Compassion requires that you assess what you need to do versus what you want to do and the
medical necessity of a certain procedure at that time. While it is important to avoid teaching
your patients that struggling ends scary interactions, or that the veterinary team is indeed scary,
you must take a long-term approach and strive that each interaction be as positive as possible.
When the need arises to change a handling plan due to a struggling patient, be sure to
communicate to the owner what you are doing and why. This is not a battle; you must strive to
make each visit as pleasant as possible. When struggling will not abate, and procedures are
necessary you must consider if sedation is required. This is discussed in module 7.

Slide 30
Having a concrete idea of when to stop the exam is facilitated by categorizing the elements of
the exam and the scheduled procedures as wants or needs and what procedures cannot be
delayed based on your patient’s behavioral responses. A want is something that is not urgent or
necessary today. If each interaction with the patient is triaged, wants are on the bottom of the
list. Wants can wait.

Wants in a seemingly healthy patient may include: oral, ophthalmic, otoscopic, and rectal exams,
thoracic and abdominal auscultation and palpation, lymph node palpation, routine blood work,
such as cbc, chemistry, and heartworm test, rectal or otoscopic temperature, vaccinations, and
nail trims. While these items are important a slight delay to reschedule and have a plan in place,
which may include sedation will make the next visit much easier and less stressful for all.
However, you must always put the health of your patient first and if serious problems are noted
during examination, which must be addressed at this visit, consider sedation options. See
module 7.

Slide 31
Identify and record what creates a pleasant interaction for each patient. Record what you do
and what the patient’s response is to that procedure. This will allow you to identify the
motivators for positive conditioning to the veterinary exam. Use an established record keeping
system or make up your own.

Hold the veterinary team accountable to using the recording system in your hospital.

Slide 32
Understanding the patient’s preferences before the exam starts at each visit will decrease the
examination time because the patient will be less stressed and easier to manage. Recording
these motivators is essential to provide a Fear Free exam. Consistent handling contributes to
positive conditioned emotional responses in your patients. Record what was effective in
creating a pleasant exam experience. For example, record if the patient is examined on the floor
vs. exam table, what food items it prefers, and whether or not pheromones or medications were
used. Change derogatory terms such as “bite alert” or “will bite” to “floor exam” “peanut butter in

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food toy held by owner.” A recording method should be standardized, easy to understand, easy
to find in the record and used by all veterinary team members. Be sure to note in a visible
location in the record if certain treats need to be avoided due to allergies.

Slide 33
In this hospital’s example, there are initials to identify the handlers, notes for the use of peanut
butter, and how the animal responded. Following these recommendations for every examination
will help to prevent FAS from escalating during care.

Slide 34
Keeping an emotional record as part of the medical record is essential for consistent care for
your patients. Consistent care helps to lower FAS. When a patient shows signs of FAS,
procedures should be stopped, and restraint or necessity of procedure reassessed.

Slide 35
Lesson 3: Client Communication

Slide 36
Communicating to the client the specific body language signs exhibited by their pet indicating
FAS enables the client to better understand the veterinary team’s actions. It has the added
benefit of educating the client regarding their pet’s emotional state. Establishing common
terminology between the client and the veterinary team allows for clear communication.

Slide 37
By the end of this lesson you should be able to:
• Define the key communication responsibilities of each veterinary team member.
• Establish Fear Free terminology used by your team.
• Explain Fear Free techniques to the client.

Slide 38
The CCR should inquire about previous veterinary visits and the patient’s level of FAS. The
veterinary
technician or veterinary assistant should observe and educate the client about their pet’s body
language and indicators of FAS as well as their response to Fear Free techniques. The
veterinarian forms a handling plan with veterinary technician or assistant and determines the
need versus wants for today’s exam. Additionally
the veterinarian communicates this to client explaining why FAS determines what care will be
delivered, how, and why.

Slide 39
The veterinarian and the other team members should work together, developing language or
signals to indicate that FAS are escalating. For example, a technician may say to the
veterinarian, “The patient has stopped taking treats,” indicating that FAS has escalated.
When communicating with the owner about their pet’s behavior, show empathy and
compassion. Use terms

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such as anxious and fearful, to show that you understand the patient’s emotional state. In
addition, by showing empathy, the team recognizes the owner’s frustration and concern
regarding their pet’s FAS. Show the client your desire to help by sharing methods that you
learned in Module 2 to help the client reduce travel FAS in their pet to improve future veterinary
visits.

Slide 40
Communication with the client should be empathetic, compassionate, and show a desire to help
the client and their pet.

The veterinary team should communicate with each other to report FAS in the patient and
strategize how best to move forward with the procedure.

Slide 41
Lesson 4: Patient Interaction

Slide 42
In this module you will learn how to create the most effective Fear Free experience for all
involved, by learning how to adjust the way you move, talk, and touch your patients to maximize
a pleasant exam experience for the patient.

Slide 43
By the end of this lesson, you should be able to:
• Explain how to use the concept of Considerate Approach based on history, observation,
and understanding
of the patient’s behavior.
• Explain how to adjust your tone of voice and movements based on the patient’s
behavior.
• Learn how to use Considerate Approach and Gentle Control handling.

Slide 44

Considerate Approach is a term that encompasses the interaction between the veterinary team
and the patient in which sensory inputs from the environment including those from the patients
themselves, the physical environment, the clients and the veterinary team and the FAS these
inputs may create when attempting to administer patient care.

Slide 45
The general concepts to employ when making a Considerate Approach are: Minimize entry into
and exit from the exam room
Speak to the client and the patient in calm tones Use slow, purposeful movements
Start with a touch gradient prior to the exam by placing your hand gently on the patient in a non-
painful area, while talking in a low, calm tone of voice
Try to move your hand while still in contact with the patient instead of lifting and replacing it in a
different area.

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Slide 46
To enable a cat to calmly accept your approach, minimize entry into and exit from the exam
room. Always speak in calm, quiet tones while moving slowly and purposefully. Open the carrier
door to allow the cat to exit if it desires, as she is deciding whether or not to exit, do not hover
over the carrier, but rather step back and turn away. Tossing one or two treats toward the carrier
opening may encourage some cats to exit.

Slide 47
In this video, you will see the Considerate Approach to a cat whose carrier is on the floor. Note
that the carrier is opened from the front and the top. The cat is offered food on one finger from
the side. Note that the patient has dilated pupils, a sign of FAS. The cat is allowed to walk out of
the carrier and investigate the room on her own.

Slide 48
Many dogs can become scared or anxious when someone they do not know toward them too
quickly, especially in a veterinary office where they may not have had great experiences in the
past. By simply altering the way you and your staff approach the patient, you can have a huge
impact on reducing their fear and anxiety.
Wait for the dog to approach you, and stand to the side. Always avert your gaze to avoid direct
eye contact, which may be threatening to some dogs. If they are happy, outgoing dogs, offer a
treat when they approach and perhaps allow them to sniff your hand. If they seem relaxed you
may be able to pet them under the chin or side of the face, do not reach over the head.

For nervous dogs, roll or toss treats toward them to see if they will eat. If the dog is very anxious
or fearful, be ready to assess the needs versus the wants for the day’s visit.

Slide 49
In the video, you will see the technician use the concept of Considerate Approach to approach a
dog. She has multiple types of rewards (see the Reward Ladder on slide 30) in a treat pouch on
her right side.
She bends down at the knees taking care to avoid eye contact or moving toward the dog. She
speaks to the patient in low, calm tones and lets the dog come to her and eat out of her hand.
Note that the dog is holding his tail down, parallel to the hind legs indicating that he is uncertain
about his interactions with her.

Slide 50
In the second video, the veterinarian enters the room and uses the same strategies. Note the
patient’s more
cautious response to the veterinarian when compared to the technician.

Slide 51
In this video you will see the proper way to pick a small dog up from the floor. Notice that the
technician is ready in her left hand with a reward that she knows the patient will eat. She keeps
the leash short and approaches the dog from the side. Before reaching for the patient, she
bends down at her knees rather than at the waist. Next, she offers food in front of the dog, but

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close enough to better position the patient next to her. As the patient is eating, she lifts him with
the opposite arm and holds him next to her body, fully supported against her side to increase
patient comfort. Finally, she places the patient on the table with a non- slip surface. Feeding
once again to distract the dog as she holds him on the table ready for the procedure.

Slide 52
As previously stated, many dogs can become scared or anxious when someone they do not
know comes toward them too quickly, especially when they are unsure of the environment.
Other movements and things to avoid with dogs showing FAS include:
• Avoid standing directly in front of or bending over them, as this may be perceived as a
threat.
• Avoid direct eye contact.
• Do not reach out to pet them.
• Keep all movements slow.
• Do not quickly offer the dog a treat.

Slide 53
The tone of your voice can provide information to the dog. They may not interpret a loud, happy
voice intended to show enthusiasm, as such, but instead may be afraid. For other dogs, a happy
tone will help them
to relax. How you move also provides information to the dog. The most important elements are
to watch the dog for signs of FAS and log those signs in the emotional record.

Slide 54
Interactive slide. Contains no audio.

Slide 55
Considerate Approach includes consideration of the patient’s sensitivities and preferences.
Always evaluate the patient before you approach for signs of FAS. Approach in a calm but
purposeful manner. Before beginning the physical examination establish a touch gradient. As
you proceed through the examination minimize changes in Gentle Control and touch gradient.

Slide 56
Lesson 5: Physical Examinations

Slide 57
A Fear Free exam should be as pleasant as possible. By using methods that minimize FAS in
your patients, you will enhance patient welfare, cultivate a culture of respect for the patient and
the client and enhance the experience of your entire team.

Slide 58
By the end of this lesson you should be able to:
• Assess needs vs. wants for an examination
• Select the best location for the physical examination

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• Assess what body systems should be examined first for individual patients.
• Choose basic Gentle Control handling techniques that minimize stress for your patients.

Slide 59
If you have assessed the patient’s fear and stress levels and you have determined that you can
proceed with a physical exam, do not automatically assume it needs to be done on the exam
table. The following slides will show you different location considerations for cats and dogs.
The information you learned in lesson 4 with Considerate Approach should be implemented as
well. There will be some repetition in this lesson with regards to Considerate Approach.

Slide 60
Every patient is an individual, some cats will feel confident and outgoing at the veterinary
hospital while others will act more shy and withdrawn. As previously stated, cats may be
threatened by someone staring at them, so discreet observation will help minimize anxiety. For
outgoing cats, let the cat come to you. Treats and toys can be offered to help establish an
interaction between the veterinarian and the patient. Unlike dogs, the fewer unfamiliar people in
the room, the less likely the cat is to become aroused. Whenever possible, some feline
practitioners prefer to complete the exam unassisted, or with one technician or assistant
providing distraction with food or petting.

Slide 61
In considering the best place to examine a cat, think beyond the exam table. Your goal in
choosing different locations is to reduce perceived threat from other animals, provide warmth,
comfort, and security, minimize potential stressful visual stimuli, and increase Gentle Control.
There are a variety of locations to consider, and all cats should be allowed to remain where they
most comfortable. Hiding is a crucial coping mechanism for stress in cats, and the cat should
be allowed to hide if she desires to do so. Examining a cat while she remains in the bottom of
the carrier hiding under a towel, or lightly wrapped in a soft blanket treated with pheromones,
can help reduce stress levels. Remember, the cat wants to be hidden from you looking at them,
but that does not mean they need to be entirely covered to feel safe.
While examining a cat who is wrapped inside or under a towel, expose only the part of the cat
needed for examination at any given time. The examination should be conducted as smoothly
and deliberately as is reasonable, with surrounding noise levels kept to a minimum. Once the
exam is complete, the findings can be discussed with the owner while the cat is allowed to relax
again.

Slide 62
As an extension of the “less is more” concept, the actual exam can proceed at the pace of the
cat’s agreement. Start by extending a finger to see if the cat will rub against it. If allowed,
massage the forehead, face, and neck, which are motions the mimic allogrooming, which is how
friendly cats interact. Head massage and continued contact with the cat will facilitate
acceptance of the examiner’s actions. Remember the 2 second, 2 tries rule, if the cat struggles
for more than 2 seconds you should stop and if you try 2 times to perform a procedure and the
patient resists, stop and re-evaluate needs versus wants.

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Slide 63
Since cats dislike change, in order to provide a sense of constancy and reassurance, move
slowly and try to maintain contact with the cat at all times. Allowing the cat to have all four feet
on a surface will help provide them with a sense of control. If the cat allows, complete all
palpation before attempting exam procedures, which are more invasive such as oral
examination, otoscopic examination, and thermometer insertion for temperature measurement.

Slide 64
This 2-minute video shows techniques you can use to make feline exams Fear Free for owners
AND cats, and shows the best location to examine a cat.

Slide 65
Not all physical examinations of dogs need to be or should be done on the exam table. The
location should be dictated by where the dog is most comfortable. For most dogs, this location
will either be on the exam table or the floor and whichever is chosen should be equipped with a
non-slip mat. Be flexible, there will be some patients who will do better if they are not in the
exam room or even the hospital. Although some dogs may do better outside of the building, the
location must be safe and secure so the patient cannot escape or this may become a liability.
Of course, if the weather permits. Keep in mind the risk to clients and patients when an outdoor
location is utilized.

Slide 66
Being able to gently handle patients should be viewed as a procedure in and of itself as
opposed to something that needs to be done so a procedure can be performed.
Given that gentle handling is a procedure, the person performing that procedure should be
solely focused on the handling. Trying to distract the patient with something positive (positive
from the patient’s perspective, not yours) is key. The handler should also focus on body
language throughout the handling and alert the veterinarian or other team member to any
changes in the state of FAS. The team member assigned to handling should remain focused on
only that role.

Slide 67
Remember the earlier discussed concepts for a Fear Free examination. Always utilize
Considerate Approach, a gradient of touch and the 3 seconds, 3 tries rule for dogs. If the dog
struggles for 3 seconds, you should stop and wait to see if you need to change something
before you try again. If the dog struggles 3 times when you attempt a procedure, stop and re-
evaluate wants versus needs. Start the examination with the least painful or problematic area.
Examine the problem or painful area last. Provide feedback to the owner throughout the
procedure about their participation. Have all equipment ready and within reach. Avoid creating
loud noises when setting equipment down on tabletops and counters.

Slide 68
If the animal shows signs of stress or resistance, stop and reassess the situation. After
increasing the value of food, try placing the patient in a location that is more comfortable for

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them. This may be on the floor or your lap. Remember the 3 second rule and if the signs do not
abate re-evaluate wants versus needs for this veterinary visit.

Slide 69
The videos on this slide demonstrate the ease of restraint when food is used during a physical
examination, the gradient of touch, Gentle Control and communication between the owner,
technician, and the veterinarian.
In the first video, the patient is restrained without food. He is more difficult to restrain, pulling
forward toward the owner, looking around, and pulling away from the handler. He is panting,
restless, is holding his tail down, all signs of FAS. Also note the veterinary team member is
gently restraining the dog, but the dog is still showing FAS.

In second video you will notice the difference in the patient’s FAS during the physical
examination based on what the veterinary team members do and how they have instructed the
client to offer delectable food. The dog is busy eating soft food from a filled toy throughout the
exam. Note the Gentle Control technique demonstrated by the technician and how much easier
it is to restrain the patient with the use of food.

The veterinarian uses a Considerate Approach, approaching the patient from the side. In
addition, she demonstrates a gradient of touch, always gently touching the patient as she
moves through the physical examination and slides her hands from place to place instead of
lifting her hand and placing it back on the patient.
Also notice how the veterinary team member gently slides her arm and hand out of the way
while she maintains a touch gradient and gently rubs the patient’s chest. All of these things
make for a Fear Free examination for the patient. Note that even though the physical
examination has been made more pleasant for the patient, owner, technician and veterinarian,
the patient still exhibits a tail down body language sign showing that he is still not completely
comfortable.

Slide 70
A Fear Free exam room creates a calm environment where patients can participate in
examinations and minor procedures without creating FAS. Being sensitive to the way patients
sense and perceive their environments helps practices select the proper equipment, supplies,
and products to create the Fear Free exam room. In addition, this knowledge will help the team
provide a physical examination with as little FAS as possible for the patient. Keeping an
emotional record for each patient will help the team minimize or eliminate FAS at subsequent
visits.

Slide 71
Congratulations! Now that you have successfully completed Module 4, please proceed to
Module 5.

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