Presented By: Mari Hopper, Kansas City University
Co-Authors: Robert Arnce, Kansas City University
Andrew Greek, Kansas City University
Jacey Greek, Kansas City University

Purpose 
The need for providing abundant clinical research opportunities in our Colleges of Osteopathic Medicine (COMs) is more important now than ever before. We have created a template for providing perpetual, streamlined, scalable, cost-effective clinical research at our institution and believe it can be implemented at other COMs. This abstract describes our research template and its outcomes. 

Methods 
Our template for creating clinical research opportunities has been in operation for the past three years.  All of our studies are structured as retrospective analyses of data obtained from the electronic medical records of patients admitted to the hospital over a specific timeframe. Initially, a broad-based research proposal is submitted to the hospital IRB on a particular topic. From this initial IRB multiple research projects are generated.  First and second-year medical students go through a standardized application and onboarding process prior to participation in research. Students are then subdivided into research groups of four. Each research group is assigned a research topic and a faculty mentor who will help them navigate through the research project.  

Results 
Since beginning in 2022, we have had 138 medical students and 9 residents who are currently participating in or have completed clinical research with our team. To date, there have been 46 individual research projects completed, 27 research posters presented, 8 papers published in peer-reviewed journals, and 7 additional papers have been submitted with publications pending. 

Conclusion 
Clinical research opportunities at Colleges of Osteopathic Medicine are needed now more than ever before. Over the past three years, our clinical research template has been proven to provide perpetual, streamlined, scalable, cost-effective clinical research.  We believe our template can be utilized to provide increase clinical research opportunities at other COMs.

Presented By: Neoreet Braha, Boston University Chobanian & Avedisian School of Medicine
Co-Authors: Kayra Cengiz, Boston University Chobanian & Avedisian School of Medicine
Nancy Donohoo, Boston University Chobanian & Avedisian School of Medicine
Emma Schmidt, Boston University College of Fine Arts
Jonathan Wisco, Boston University Chobanian & Avedisian School of Medicine
Crystal Zhu, Boston University Chobanian & Avedisian School of Medicine

Purpose 
Illustrating medical concepts is an important way physicians convey information to patients. Enhancing physician drawings, guided by a previously published instructional video outlining optimal artistic techniques for explaining concepts, has the potential of enhancing patient comprehension. In this study, drawings created by physicians before and after viewing the instructional video were evaluated by individuals with a background in art and architecture, utilizing a previously validated rubric. 

Methods 
We collaborated with five individuals holding art and architecture degrees to evaluate physicians' drawings of medical concepts before and after viewing the instructional video. An established aesthetic score rubric, comprising six categories--Layout, Visual Clarity, Color, Sequence/Directionality, Hierarchy, and Style--was employed for this assessment. The drawings were presented in a random order for each rater. Statistical analyses were conducted to quantify the differences in ratings assigned to drawings before and after exposure to the instructional video. 

Results 
The findings from this study show a statistically significant difference in the mean aesthetic ratings of physician drawings before and after viewing the instructional video (t(3) = -7.22, p = 0.005). Notably, the drawings created post-instructional video demonstrated a higher mean aesthetic score compared to drawings created pre-instructional video. These results suggest that utilizing the instructional video to provide physicians with guidance on optimal artistic techniques for conveying medical concepts through drawings improves the quality of physicians' drawings and could potentially enhance patient comprehension of medical information. 

Conclusion 
Our findings suggest that the instructional video assessed in this study effectively enhances physicians' drawing skills and improves the overall quality of their illustrations. The administration of this instructional video has demonstrated a tangible improvement in physicians' ability to depict medical concepts, pointing towards its potential to enhance the health literacy of patients through clearer visual communication.

Presented By: Melissa Armas, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine
Co-Authors: Karla Carvajal, Florida International Universit Herbert Wertheim College of Medicine
Gloria Coronel-Couto, Florida International University Herbert Wertheim College of Medicine
Amala Landa-Galindez, Florida International University Herbert Wertheim College of Medicine

Purpose
Medical students may feel ill-prepared to handle ethical dilemmas experienced during clinical rotations, with resultant moral distress. We aimed to study ethical dilemmas experienced by students during their FIU Herbert Wertheim College of Medicine Internal Medicine (IM) Clerkship, and to specifically assess challenges related to Social Determinants of Health (SDOH). 

Methods 
A reflective assignment was introduced in the IM clerkship where students were asked to describe a witnessed ethical dilemma. Students were asked to describe the clinical scenario, ethical issue, emotional response(s), professional obligations, and alternative management approach/values. Interactive small-group debriefing sessions were introduced where students  discussed individual cases and then presented to the larger group. 

Results 
357 assignments were deidentified. Authors reviewed/categorized them into primary ethical themes: social/organizational, lack of professionalism, patient privacy/confidentiality, shared decision-making, and primacy of patient welfare. Moral distress was determined by consensus based on emotionally-charged words. 33% of analyzed assignments contained themes in social/organizational ethics. 88% of analyzed assignments presented with moral distress. Words such as frustrated, helpless, and ashamed described strong emotional responses. Preliminary data from small group debriefing sessions suggests that 45% of the cases presented by the students were related to SDOH. Important issues included homelessness, immigration/insurance limitations, and substance abuse. 

Conclusions 
We found numerous examples of moral distress and ethical challenges faced by students during clinical rotations related to SDOH. Sample problems included lack of insurance limiting ability to receive life-saving interventions or adequate follow up care as well as cases related to immigration status, incarceration, and substance abuse. Debriefing sessions provided students with resources and opportunities to discuss viable options to address similar future challenges with patients/caregivers. Students reported that discussion of care strategies was empowering, and the reflective sessions left them better prepared for future challenges in patient care.

Presented By: Nancy Donohoo, Boston University Chobanian & Avedisian School of Medicine
Co-Authors: Neoreet Braha, Boston University Chobanian & Avedisian School of Medicine
Kayra Cengiz, Boston University Chobanian & Avedisian School of Medicine
Cassandra Lee, Boston University Chobanian & Avedisian School of Medicine
Brandon Oddo, Boston University Chobanian & Avedisian School of Medicine
Tony Robinson, Boston University Chobanian & Avedisian School of Medicine
Emma Schmidt, Boston University College of Fine Arts
Noah Siegel, Boston University Chobanian & Avedisian School of Medicine
Jonathan Wisco, Boston University Chobanian & Avedisian School of Medicine
Crystal Zhu, Boston University Chobanian & Avedisian School of Medicine

Purpose
Previous studies have investigated the use of clinical illustrations to improve health literacy. Drawing experience varies amongst healthcare professionals and can be difficult to develop without guidance. A video tutorial was created to assist clinicians in improving the comprehensibility of their clinical illustrations.

Methods
Four physicians of Boston University Chobanian & Avedisian School of Medicine illustrated concepts related to their specialty: disc herniation (DH), Parkinson's disease (PD), sickle cell (SC), and X-ray imaging (XR); watched a video tutorial; and re-illustrated those concepts. For each concept, undergraduate student participants took a pre-quiz, saw either a pre-video (A) or post-video (B) image, and then took a post-quiz. The quiz scores were analyzed for differences in performance.

Results
We conducted paired sample t-tests for each of the eight testing conditions and found that quiz scores improved in all disciplines [DH-A: t(20) = 5.767; p <0.001; DH-B: t(20) = 4.903; p <0.001; PD-A: t(22) = 2.237, p = 0.018; SC-A: t(22) = 4.746, p <0.001; SC-B: t(21) = 1.914, p = 0.035; XR-B: t(22) = 2.113, p = 0.023]. Independent sample t-tests showed higher test score improvement for SC [t(43) = 1.707, p = 0.048] after viewing the post-tutorial image than when viewing the pre-tutorial image. The starting artistic ability of a physician is a confounding variable and may explain the lack of significant difference in post-test scores between A and B groups.

Conclusion
Clinical illustrations can enhance patient-provider communication and improve patient understanding across a variety of disciplines. Video tutorials are low-cost educational tools with the potential to improve clinical drawing skills and health literacy. Future studies should recruit participants with a wider range of health literacy to better assess the impact of image quality on understanding.

Presented By: Mirela Bruza-Augatis, National Commission on Certification of Physician Assistants
Co-Authors: Joshua Goodman, National Commission on Certification of Physician Assistants
Roderick Hooker, Northern Arizona University
Andrzej Kozikowski, National Commission on Certification of Physician Assistants
Dawn Morton-Rias, National Commission on Certification of Physician Assistants
Kasey Puckett, National Commission on Certification of Physician Assistants

Background/Purpose
The number of postgraduate (PG) fellowship/residency programs for physician associates/assistants (PAs) has rapidly grown. These programs provide PAs with the opportunity to gain specialized expertise in various medical disciplines. However, the number of PAs who complete these programs and their specific characteristics remain unknown. Therefore, we aimed to explore this important topic.

Methods
We analyzed 2021 data from the National Commission on Certification of PAs, comparing demographics and practice characteristics of PAs who completed PG fellowship/residency vs. those who did not. Analyses consisted of descriptive and bivariate statistics, along with quantile regression.

Results
In 2021, 113,510 of 158,470 board-certified PAs provided their PG fellowship/residency status. Of those, 5,859 (5.2%) completed a PA PG fellowship/residency. Our analyses revealed several significant differences (all p<0.001) between the two groups. PAs who had completed a PG fellowship/residency, in comparison to those who had not, were more likely to be older (median age of 42 years vs. 38 years), male (42.4% vs. 29.4%), Black/African American (4.8% vs. 3.3%), and Hispanic/Latino(a/x) (8.0% vs. 6.6%). Furthermore, PAs with a PG fellowship/residency were more likely (all p<0.001) to hold a doctorate (9.1% vs. 1.9%), work in hospitals (51.0% vs. 40.8%), and have been certified for 21 or more years (29.6% vs. 17.0%). The unadjusted analysis revealed that PAs who had completed a PG fellowship/residency earned a median income of $10,000 more than those without (p<0.001). However, after adjusting for demographics and practice characteristics, the income difference was reduced to $1,501 (p=0.003).

Conclusions
Our research suggests that a significant number of PAs undertake a PG fellowship/residency and sheds light on their unique characteristics. While our analysis did reveal a marginal income difference, favoring those with a PG fellowship/residency, future research should explore the income growth trajectory across these two groups to better understand the financial implications of completing a PG fellowship/residency.

Presented By: Simisola Onanuga, Imperial College London
Co-Authors: Raksha Aiyappan, Nanyang Technological University
Ana Baptista, Imperial College London
Michael Fu, Imperial College London
Susan Smith, Imperial College London
Xinyu Ye, Imperial College London
Tangming Zou, Nanyang Technological University

Purpose
Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals have health needs specific to their identities but face discrimination that often translates into poor healthcare. Evidence suggests doctors are inadequately trained to care for LGBTQ+ patients, and medical students are well-placed as the future workforce to establish affirming behaviours. This study garners patients' LGBTQ+ healthcare experiences, where limited qualitative evidence exists, and explores whether students have insight into these experiences. 

Methods 
30 LGBTQ+ healthcare users and 20 students divided evenly across Singapore and the United Kingdom (UK), two different countries legally and culturally, consented to semi-structured interviews evaluating their LGBTQ+ healthcare perceptions. Thematic analysis was conducted with a collaborative, iterative process involving five investigators over Zoom videoconferencing with frequent auditing of data interpretation. 

Results 
Most users described implicit biases with a lack of support and professionalism from doctors, hindering health outcomes. Users expressed instances of misgendering and lack of recognition of sexual and gender diversity; students appreciated the need to acknowledge patient identity. Perceptions surrounding sexual, reproductive, and mental health were similar between users and students in both countries, whilst users' voices on the complexity and dissatisfaction of gender-diverse care contrasted with students' lack of insight. Singapore users were more concerned with sociolegal acceptance affecting health needs, whilst UK users noted more nuanced barriers to healthcare. Although many students were unsure about specific health needs and perceived a lack of training, they expressed willingness to create an equitable healthcare environment. 

Conclusions 
LGBTQ+ users provided powerful narratives on discrimination surrounding their healthcare needs. To address these, medical students must be encouraged by healthcare educators to develop identity-affirming behaviours as future change-makers and challenge cis-heteronormative views that may be dehumanising. Alongside vital institutional changes tailored to each country, patients and students' collective action would create meaningful educational opportunities to reach culture change.

Presented By: Ling Cao, University of New England
Co-Authors: Kin Ly, University of New England

Purpose
Interprofessional and multidisciplinary collaborations are critical for providing comprehensive and efficient care to patients, especially for those with chronic illnesses, which highlights the importance of interprofessional education (IPE) for all health professions students. With the increased awareness of how social determinants of health (SDOH) can affect a patient's health, we designed a new virtual IPE program that aimed to introduce the public health problem solving paradigm (Guyer 1998) to health professions students. By adapting this paradigm in patient-centered care, the program guided students through the process of patient information review, root-cause analysis, and intervention development. This abstract describes the program and the early outcomes. 

Methods
The program was piloted in AY 2022-23 with 28 students from various health professions (osteopathic medicine, pharmacy, physical therapy, dental, nursing, and applied nutrition dietetics) and public health major forming 7 teams. Each team generated a patient case using their clinical experiences and provided resources and created a patient-centered framework that incorporated patient's medical conditions, socioeconomic status, and community and environmental factors. Students then used the framework to design potential interventions to improve the overall health of their patients. 

Results 
Students collectively showed significant improvement in the Interprofessional Socialization and Valuing Scale (ISVS-21) that measures students' potential abilities to function in an interprofessional team (pre 84.7±17.9 vs. post 102.6±19.1), and in the perceived competencies in recognizing the impact of SDOH to patient health and identifying resources to overcome the consequent health care challenges (pre 18.9±6.0 vs. post 27.9±5.7). Students agreed that the program achieved its learning objectives (4.5±0.60 out of 5) and improved their skills in taking socioeconomic context into considerations when developing interventions. 

Conclusion 
The results demonstrated the early success of the program, which has encouraged us to continue the program and more in-depth evaluation will be conducted in the future.

Presented By: Kyle Bauckman, Nova Southeastern University
Co-Authors: Thura Al-Khayat, Nova Southeastern University
Stefanie Carter, Nova Southeastern University
Daniel Griffin, University of Texas at Tyler School of Medicine
Maria Ortega, Nova Southeastern University
Vijay Rajput, Nova Southeastern University

Purpose
Curiosity is a crucial aspect of clinical reasoning. Learner curiosity is inherent and adaptable based on environment. Curiosity is most well defined and analyzed by the work Mason et. al. describing and validating the five-dimensional curiosity scale.   Prior studies suggest curiosity is hindered in medical school curriculum. However, little empirical data has emerged. We aimed to utilize the five dimensions of curiosity scale to track evolution of curiosity during the pre-clerkship curriculum.

Methods
The IRB approved prospective qualitative study of baseline curiosity assessment.  One cohort was surveyed with the validated five dimensions (5DC) of curiosity scale during the first week of matriculation the last week of their M1 curricula. Surveys were confidential and data de-identified prior to analysis.   The 5DC survey uses five questions per category to get a composite score from a 1 to 7 range.  Scores were aggregated based on types of curiosity described by Mason et. al. Outcomes were aggregated to provide class composites of curiosity and pre and post outcomes were statistically compared.

Results
There was no statistical significance in five scales of dimension (n=52) for the pre- and (n=47) post survey. Aggregate cohort results showed high levels of joyous exploration and social curiosity. There was an upward but not significant trend for all curiosity domains.

Conclusions
Our findings suggest cohort curiosity was not hindered by our M1 curriculum.  The upward trend for all curiosity domains suggests that at a minimum our curriculum augmented previously existing characteristics of curiosity.  Future investigations will explore additional cohorts and longitudinal evolution of curiosity in progressive academic years.  These outcomes suggest curiosity for adult learners is not easily manipulated by educational modalities.  This emphasizes the need for inclusion of curiosity in a holistic admissions review.

Presented By: Samir Anadkat, Tulane University School of Medicine
Co-Authors: Dolly Anadkat, Tulane University School of Medicine
Paula Majeau, Tulane University School of Medicine
Guenevere Rae, Tulane University School of Medicine

Purpose 
Medical students are continuously learning new concepts and a host of related facts. With the constant pressure to perform well on tests, it is often easy to resort to study methods which are heavily focused on memorization. Every physician in training is required to develop strategies to organize learned knowledge so that new information and experiences can be linked to it for effective patient care. One of the tools to promote this deeper learning is concept mapping. We decided to utilize the existing PAL (Peer Assisted Learning) tutor program to promote conceptual learning using the concept mapping tool. 

Method 
Newly recruited PAL tutors were given 6 hours of training in concept mapping. M1 students were exposed to concept mapping during orientation. Three 2-hour workshops were conducted with the help of the learning specialists, faculty, and PAL tutors. In small groups of 4-6, students were actively engaged to co-create concept maps in all disciplines including: Physiology, Anatomy, Histology, Biochemistry, and Genetics. All sessions were open to every M1 student and were voluntary to attend. A postworkshop survey was conducted. PAL tutors were also encouraged to utilize concept mapping in their individual tutoring sessions for all struggling students seeking help. 

Results 
This initiative was well received by students. Out of 194 M1 students, 96 students participated in one or more of these workshops, of which 89 students attended more than one workshop. The survey result indicated high satisfaction (4.6/5) among attendees. In addition, about 70% of students indicated that they would incorporate concept mapping tools in their regular studies. Moreover, 91% of students showed interest in attending such sessions in future.

Conclusion
Spontaneous small group concept mapping sessions are being independently organized by students indicating positive adaptation of this learning strategy by students.

Presented By: Jordan Moberg Parker, Kaiser Permanente Bernard J. Tyson School of Medicine
Co-Authors: Delores Amorelli, Kaiser Permanente Bernard J. Tyson School of Medicine

Purpose
Medical education (MedEd) scholarship receives far less institutional attention and support than other educator competencies and has less faculty development devoted to it. Without the opportunity to build skills and conduct education scholarship, it is difficult for undergraduate medical education (UME) faculty to see themselves as medical education scholars, an identity which can contribute to and improve faculty's teaching practice. Scholarship of Teaching and Learning (SoTL) is a logical extension of the scholarly teaching practices that many faculty are already engaged in, and thus an optimal place for faculty to begin thinking about themselves as medical education scholars. Our research questions were: Does engaging in SoTL make UME faculty feel like medical education scholars? How does engaging with SoTL contribute to the construction of their professional identities and impact their practice of medical education? 

Methods 
The study population was UME faculty at a private, allopathic medical school. A 20-item survey with multiple-select, Likert-style, and open-ended questions asked faculty to select their professional identities, identify their experience with SoTL, and assess their beliefs about their skills related to medical education scholarship. Two open-ended questions asked faculty to consider how learning about or working on a SoTL project impacted their professional identities and their practice of medical education. 

Results 
Clinician (92%) and Educator (88%) were the most selected professional identities, and only 20% selected Education Scholar. 80% of respondents agreed that learning about SoTL increased their confidence in their ability to conduct medical education scholarship. The qualitative data revealed that engaging in SoTL training or projects made them feel more like medical education scholars and SoTL work positively impacted their practice. 

Conclusion 
SoTL has potential to impact the ways in which undergraduate medical educators identify themselves and their abilities as education scholars, including the potential to impact practice by changing faculty's perceptions of themselves and their skills.

Presented By: John Lowry, Central Michigan University College of Medicine
Co-Authors: Andy Bazakis, Central Michigan University College of Medicine
Judy Blebea, Central Michigan University College of Medicine
Nicole Wright, Central Michigan University College of Medicine

Purpose 
Peer observation of teaching can contribute to improved teaching practices with several models described. We sought to design and implement a developmental model of peer observation of teaching that would be firmly grounded in self-determination theory and to assess its effectiveness. 

Methods 
We created a peer observation of teaching program for medical faculty based on the principles of self-determination theory and the psychological need for autonomy, competence, and relatedness. Faculty autonomy was optimized by allowing for voluntary participation, ability to select the peer observer across any discipline and to set the goals. Faculty could choose to observe an in-person, virtual or recorded session of teaching. Training on peer observation and coaching skills was provided. Faculty competence was enhanced by an immediate debriefing and a subsequent feedback process. The program's design fostered a community of practice to enhance relatedness. 

Results 
There were 20 faculty who participated in the program. Faculty overwhelmingly rated the program as having a positive impact on their competence in teaching and professional development. All respondents indicated they valued the program's structure of providing a choice of peer observer and peer engagement. Only 44% of participants agreed that participating would improve their ability to get promoted. Open comments indicated that while faculty enjoyed seeing different teaching styles and receiving feedback, it was sometimes a challenge to set up observation appointments around busy schedules. 

Conclusions 
A peer observation of teaching program that maximizes faculty autonomy, competence, and relatedness can be very effective and received well by faculty. The sense of ownership and control over their professional growth fosters enthusiasm. Emphasizing relatedness by creating a supportive community of practice helps faculty members feel connected, valued, and engaged in a collaborative learning environment. This portable framework, maximizing faculty self-direction and connections, can transform teaching practices. Self-determination principles are vital for productive peer reviews.

Presented By: Peter Vollbrecht, Western Michigan University Homer Stryker M.D. School of Medicine
Co-Authors: Natascha Heise, Eastern Virginia Medical School

Purpose
At many medical schools there is a concerning shortage in the support and recognition of work related to outreach initiatives. This is further corroborated by the lack of faculty mentorship regarding these efforts. As a result, this effort often goes unrewarded as faculty fail to produce publications and presentations that showcase the scholarly outcomes of their work. To address this issue, an international community of practice was created to bring medical professionals together to exchange innovative ideas, share experiences, and collaborate on community outreach, research, and engagement efforts (CORE). 

Methods
CORE was established in 2021 and has since continued its mission with ongoing recruitment to expand its number of members. Guided by two chairs, this initiative conducts bimonthly virtual meetings for discussion and mentorship as well as in-person meetings at various national and international conferences. Membership is free and open to anyone interested. 

Results
To date, CORE has successfully brought together a diverse community of 60 members from 34 different institutions, spanning 21 states in the USA, as well as Canada and the Caribbean. This network comprises a blend of both seasoned experts and novices. With an average attendance of 15 members in each session, CORE serves as a platform for collaboration. Members actively join forces to create abstracts, coordinate focus sessions, and prepare for oral presentations at renowned conferences, including AMEE, IAMSE, and ASPBP. CORE's dedicated community of practice has shown promising results in connecting faculty across America and enabling collaboration within the outreach realm. Initiatives like these not only enhance the quality and impact of outreach efforts but also elevate the recognition and scholarly contributions of individuals and institutions in the field of medicine, ultimately benefiting both the medical community and the communities they serve.

Presented By: Stefanie Attardi, Oakland University William Beaumont School of Medicine
Co-Authors: Danielle Bentley, University of Toronto
Kristina Lisk, University of Toronto
George Nader, University of Toronto
Victoria Roach, University of Washington

Purpose 
Academic conferences employ curated symposia and poster sessions which serve as a dais to convey polished work, offering limited opportunity for suggestions or insights from the scientific community throughout the research process. These events typically require significant fiscal and temporal resources to organize, execute, and attend. This presentation describes the implementation of an unconference structure in the context of anatomy education research. 

Methods 
The Unconference was an informal, participant-driven, one-day meeting that began with a democratic election of discussionary topics to fill a skeleton agenda and populate discussion topics for breakout sessions. Content discussed in the break-outs was supported by the sum of experiences of the attendees; thus representing cooperative knowledge rather than those of one "sage on a stage". The event culminated in Harvard-Macy Step-back consultations where attendees each proposed projects, and received project feedback and advice; encouraging peer-to-peer discourse, and contributing to an ad hoc community of practice. 

Results 
Attendees were thirty-three scholars (7 students, 10 junior-level, 12 senior-level) from 16 North American institutions, with research experience averaging 7.2yrs (range:0-44yrs).  Attendee-chosen discussionary topics included study designs and research methods, psychometrics, and research dissemination. This format removed the social hierarchy often associated with academic expertise while encouraging networking, collaboration, and embracing diverse perspectives and approaches to problem-solving. Attendees remarked that they felt empowered to initiate collaboration with scholars they would have otherwise been reluctant to approach at a traditional conference. 

Conclusion 
By fostering an iterative and collaborative design process, it is hypothesized that participants' research will be enhanced, and ultimately yield higher impact results; thus advancing each participant's contribution to their respective fields of inquiry. While this Unconference was situated within the context of anatomical education research, it is expected that similar Unconferences could be launched in other educational research disciplines and yield similar results.

Presented By: Deniz Goodman, Bascom Palmer Eye Institute
Co-Authors: Elena Bitrian, Bascom Palmer Eye Institute
Alana Grajewski, Bascom Palmer Eye Institute
Ta Chen Peter Chang, Bascom Palmer Eye Institute
Eleonore Savatovsky, Bascom Palmer Eye Institute

Purpose
Learning microsurgery is one of the most challenging aspects of ophthalmology residency. Novel synthetic eye models show promise in facilitating hands-on instruction and practice in the wet lab environment. We compare the cost, required preparation, and anatomical fidelity between a synthetic eye model (SE), pig eyes (PE), and cadaver eyes (CE) for teaching pediatric glaucoma surgery.

Methods
Information collected from eye banks and scientific supply stores was used to determine the cost of eyes and materials. Surgical course instructors were polled to established representative wet-lab scenarios for cost estimate calculation.

Results
The average cost of a SE, PE, and CE is $70, $2, and $250, respectively. Relative to using CE, calculated savings are as follows: hosting a one-time wet lab for a typical residency class of 4 (PE: $992, SE: $720), a longitudinal (12 sessions/year) wet lab curriculum of the same class size (PE: $11,904, SE: $8,640), and a conference skills transfer session of 20 attendees (PE: $4,960, SE: $3,600). SE require significantly less intensive preparation, only necessitating lubrication and a 15-minute water soak, compared to PE and CE that must be stored at low temperatures to prevent degradation and soaked in formalin for several hours or injected with saline or viscoelastic agents to achieve physiological globe pressures. SE features a clear cornea and a human-like Schlemm's canal, thereby providing a more realistic model for teaching goniotomy and ab externo trabeculotomy compared to PE which may have a cloudy cornea, segmented canal, and tougher trabecular meshwork.

Conclusions
The synthetic eye model represents a cost-effective and convenient alternative to cadaver eyes and pig eyes for teaching pediatric glaucoma surgery.