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Gazing into Cleo's eyes

Dr Linda Lippa with medical students
UC Irvine Advancement
Dr. Linda S. Lippa and CLEO are hard at work improving UC Irvine medical students' knowledge of the eye and ability to diagnose vision problems.

UC Irvine medical students learn to recognize eye ailments, training that had all but disappeared from medical school curricula

CLEO may resemble a mere wig stand, but she is far more.

The mannequin, which UC Irvine ophthalmologist Linda S. Lippa, M.D., assembled in her garage, is an ingenious device that can assess a medical student's ability to recognize conditions and diseases inside the eye.

Lippa developed CLEO, short for Clinical Learning Experience in Ophthalmoscopy, to use as an assessment tool for an exercise on the California Consortium for the Assessment of Clinical Competence exam at UC Irvine. The bust provides a lifelike simulation of the interior of the eye, or retinal fundus, using film slides of actual patients' retinas.

"This allows students to practice retinal exams on CLEO without the pressure of worrying that they are hurting a patient as they learn," says Lippa, who has built four of the mannequins. It also lets professors assess "what the students are able to visualize and describe, since we know what is on the slide."

As director of ophthalmology medical education at UC Irvine's Gavin Herbert Eye Institute and Department of Ophthalmology, Lippa had become alarmed by the lack of education about the eye in medical schools nationwide. In 2004, only eight U.S. medical schools still required ophthalmology in the clinical curriculum.

Lippa decided to perform longitudinal studies on medical students' examination skills, which included encounters with CLEO. Her findings prompted the consortium to use CLEO as part of the California clinical skills assessment exam.

"Since assessment drives the curriculum, once CLEO appeared on the statewide exam for all medical students, curricular deans and committees took notice," Lippa recalls.

With CLEO's aid, Lippa has developed a novel integrated curriculum that grounds UC Irvine medical students in the essentials of the eye. It is a model that has been adopted by other medical schools and by other marginalized medical specialties besides ophthalmology.

"Not only are diseases that affect the eye missed, but the eye also holds secrets for best medical practices for other specialties," Lippa says. "The way I approach teaching ophthalmology is by demonstrating that the knowledge and skills make better doctors, regardless of specialty."

As a longtime affiliate of the Association of University Professors of Ophthalmology (AUPO), she also has worked tirelessly to raise national awareness of the need to train medical students in general ophthalmology. With AUPO's recent adoption as formal associates the members of the Consortium of Medical Student Educators, a group Lippa founded, her efforts to increase medical students' knowledge of eye conditions and diseases have gained influence nationally and internationally.

Ultimately, Lippa believes, this will improve the quality of patient care through timely diagnosis and referrals for specialized vision treatment.

"CLEO and I are doing everything we can to ensure that our doctors are well trained in ophthalmology," she says.