ASE 2024 Abstracts

Background: Committees dedicated to diversity, equity, and inclusion (DEI) are not commonplace within departments of surgery. Even rarer are joint initiatives for residents and faculty. We aim to describe a model for creation of a collaborative committee within a department of surgery to better foster and advance the ideals of DEI. Methods: An informal needs-assessment was performed amongst the general surgery residency, advanced practice providers, and faculty. Other DEI groups throughout the institution were engaged for feedback and interdisciplinary collaboration. Results: Gaps were identified in social support for those from diverse backgrounds, advocacy and recruitment, general DEI education, and research. Three pillars were formed: Social support, Advocacy/Education, and Research. The overall group and each pillar are co-led by residents and faculty. In less than a year, the group has launched a cultural complications M&M curriculum, hosted the first city-wide LGTBQ in surgery event, initiated multiple research projects, created a safe space for discussion and support, and advocated for recruitment DEI initiatives. So far, the group consists of 48 residents, faculty, advanced practice practitioners, and staff. Conclusions: An intentional, collaborative effort between residents and faculty in a department of surgery can successfully result in an effective partnership to advance DEI initiatives.

Background: Our institution published a validated surgical disparities curriculum (SDC) for third-year medical students (MS3s), based on the Surgical Disparity Framework created by the American College of Surgeons. This curriculum has been well received, with knowledge gain, retention, and improved identification of peri-operative disparities. In response to the interest of our fourth-year medical students (MS4s), we designed a service-learning project allowing them to learn about peri-operative disparities and create SDC modules. Methods: MS4s were invited to create modules addressing various surgical disparity topics. The IPARDE framework guided our SDC building service-learning project. Results: Investigation: MS4s explored and selected a topic of interest from a catalog of surgical disparities cases. Preparation: MS4s reviewed educational materials and templates for creating an SDC module. Action: MS4s developed SDC modules by identifying pre-session adjuncts and developing guided discussions and presentations. Reflection: The student-prepared SDC modules were reviewed. Demonstration: MS4s delivered the SDC module to a new cohort of MS3s. Evaluation: MS4s were evaluated by self, peers, residents, and clerkship director. Conclusions: This service-learning opportunity offers a sustainable pathway for SDC development and enables MS4s to learn curriculum building, increase their knowledge of surgical health disparities, and gain confidence in various domains of this field.

Background: SLICC, situated in eastern Pennsylvania's third-largest metropolitan area, was established to address the pressing need for cost-free healthcare among low-income populations. Medical students, upon conducting a community health targeted needs assessment, identified distrust of healthcare, limited access, and a lack of health education as significant challenges. Responding to community concerns, students initiated SLICC, a clinic uniting various healthcare professionals and educators to provide medical services and education to locals. Methods: Before SLICC's inauguration, students immersed themselves in the community, building trust and understanding barriers to healthcare. The community health targeted needs assessment guided initial priorities. Current student-led initiatives include primary care visits, A1C testing, hot meals, and clothing distribution. Future plans involve vaccines, expanded testing, and a head and neck screening protocol. Results: Consistent surveying revealed increased community comfort in seeking medical care. Epidemiology data demonstrated improved healthcare utilization. This student-led clinic helps facilitate healthcare interactions among a diverse population, promote trust, equity in care, and bring an inclusive, friendly face to an underserved community. Conclusions: Longitudinal community engagement remains essential to addressing evolving needs. SLICC continues to harness volunteer healthcare providers and students, resources, and the voices of medically underserved neighbors to provide free point-of-care medicine.

Background: Surgery Departments nationwide are establishing resident-led Diversity, Equity, and Inclusion (DEI) committees—empowering and educating trainees to actively contribute to the pursuit of surgical health equity. However, many resident-led initiatives struggle with organization and sustainability, often floundering when passionate leaders graduate. After two years of experience, our Resident DEI committee aims to share challenges faced, organizational changes made, and feasible strategies needed for sustaining a DEI committee during rigorous surgical training. Methods: Committee leaders used the ADKAR Change Management Model to bolster the organization, recruit new members, and transition the initiative into an annually reproducible paradigm. Results: Awareness: understand challenges related to organization, funding, and communication of ideas to administration Desire: increase ownership for current and new members using defined roles and clear meeting structures Knowledge: prioritize transitions of leadership with opportunities for skill growth and academic involvement Ability: collaborative discussion at committee meetings for improvement of initiatives Reinforcement: integration of plans with department’s Vice Chair of DEI and faculty DEI committee for review, support, and guidance Conclusions: Prioritizing the sustainability of a resident DEI committee ensures long-term growth, continuous prosperity, and can better educate and equip future surgeons in delivering equitable care for all patients.

Background: Our department has piloted an elective experience wherein medical students gain an understanding of trauma surgery AND first-hand immersion in the socio-political contexts that create obstacles for victims of violent injury. Patients navigating complex aftercare and rehab on limited resources run into tremendous obstacles––and are disproportionately underrepresented minorities who already experience a lack of access and distrust of the medical system. Methods: This elective was conceived and developed with medical students from underrepresented backgrounds. Participating students spend half their time working in the OR at a Level 1 trauma facility alongside attendings and residents. The other half is spent serving as navigators for a recently-discharged trauma patient and their family—offering support and advocacy during clinical follow-ups and home visits. Results: Students are introduced to the intersection of trauma-informed care and health disparities by meeting regularly with community members who have experienced violent injury; social workers; trauma therapists; and the staff of our hospital-based violence prevention program. Conclusions: Participants navigate the unique challenges facing post-discharge trauma patients. The longitudinal character of the elective allows students to build trust with patients and improve outcomes by being effective advocates. Additionally, they gain insights into patient needs that will serve them as future

Background: Early outreach to students who are underrepresented in medicine (URiM) can increase their subsequent interest in medical careers. Through our surgical simulation center, we aimed to create interactive sessions for students, particularly from URiM backgrounds, to learn about surgery in an approachable and supportive environment. Methods: We created an outreach program for high school students from under-resourced schools who historically have limited exposure to careers in healthcare. During this two-hour simulation-based curriculum, students rotate at four stations: knot tying, laparoscopic skills, endoscopy, and virtual-reality robotic tasks. General surgery residents and faculty teach each station and discuss their personal backgrounds and experiences in pursuing a career in healthcare. Results: Over the past two years, we hosted 13 outreach events and reached 193 students. The subjective post-session evaluations highlight recurring themes: students have limited or no knowledge of medicine prior to the session, hands-on activities are helpful in understanding different aspects of surgery, and the session helps them gain insight into various forms of surgical technology. Conclusions: This high-impact novel program has been well received by students and faculty from our community. This type of program can have a significant impact on career decision-making at an early stage of student's education.

Background: Postgraduate surgical training programs in high-income countries (HICs) are one of the resources for the expansion and training of the surgical workforce mentioned by the Lancet Commission on Global Surgery. Fellowships expose trainees from low- and middle-income countries (LMICs) to new surgical technologies, protocols and system implementations, but also provides bidirectional learning opportunities. The purpose of our study is to understand the perspective of fellows from LMICs who complete fellowships in HICs. The goal is to understand the structure of fellowships that will best support the goals and objectives of the fellows to benefit surgical and clinical care when they return home. Methods: The study is a qualitative explorative project using semi-structured interviews to provide a broader understanding of their experience, without limitations. A snowball sampling strategy was used to recruit the participants. Results: This is a preliminary study where we will discuss the shared experiences of 6 fellows who completed 6-24 months fellowships in a variety of HICs. Based on their shared experiences, we will discuss challenges faced with completing their clinical fellowships, as well as those related to the implementation of their learning when returning home. We will also discuss recommendations for ways to improve fellowships targeted