Module 1: Independent Research Studies

There are relatively few published studies about eye care in developing countries, and Unite For Sight encourages Global Impact Corps volunteers to undertake research studies to contribute important knowledge. Pursuing a research project is a challenging and rewarding experience, and this opportunity enables the researcher to pursue an in-depth original study about a topic of interest. Many Unite For Sight volunteers who have pursued research studies have published their results in peer-reviewed journals or presented them at conferences.

Considerations For Research Abroad

• Be Proactive. Anyone involved in research must be proactive, motivated, and dedicated to the hard work necessary to conduct a research study.

• Consider Language Barriers. Many of the patients that you meet internationally will not know English, so researchers often work with a translator. For survey-based research, it is important that the questions are short, succinct, easy to understand, and culturally relevant.

• Be flexible. When you arrive in the field as a volunteer, new and unforeseen obstacles to your research will certainly arise. It is important that you be prepared to be resourceful, patient, and devoted to your research study design and protocol.

Interview With Abraar Karan, Yale University Student, Unite For Sight Volunteer of the Year 2008

Why did you decide to pursue a research study?

Research is central to expanding on and improving the services provided in medicine, public health, and all other academic fields. I felt that pursuing a research study while volunteering would be extremely beneficial. Informed consent is often not prioritized when dealing with impoverished and uneducated populations, and a paternalistic model of medicine can sometimes ensue. Thus, I felt that a study on improving the informed consent process for villagers would be an impactful project.

Describe your research study and results.

My study focused on the effect of using a visual aid in addition to a scripted informed consent for patients undergoing cataract surgery. The study was a case-control study in which one group of randomly selected patients was read a scripted informed consent prior to surgery while another randomly selected group was read the same script as well as shown a visual aid. Both groups were tested with a short questionnaire on the background of cataracts, the procedures involved in phacoemulsification surgery, and the risks/benefits and postoperative course of action before informed consent, directly after informed consent, and one day post-operatively. The results were compared and showed that the group which was exposed to the visual aid had significantly higher scores when comparing pre-informed consent to one-day postoperative quiz scores, showing greater understanding and retention of material.

What is the importance of your research study, and how will you share your results?

The importance of the study is that it demonstrates that the use of multimedia as an educational device can help overcome the barrier to educating illiterate and indigent populations that are often the targets of medical interventions that they may not fully understand or approve of. The results are in the process of being published in a peer-reviewed medical journal so that they may advise physicians practicing in resource limited settings on practical ways to improve patient care.

What steps did you take to develop your research study?

I contacted a physician from the Yale Department of Ophthalmology who could advise me and overlook my work from my initial grant proposal to my final publication. He presented me with a question that he wanted to answer as a practicing ophthalmologist, and from it we designed a successful study. He was extremely helpful in advising me while I was abroad and came across obstacles that required me to reorganize my study.

I needed to receive approval of my study from the Institutional Review Board (specifically the Human Subjects Committee of Yale University) to ensure it was not violating any ethical principles of research. Also, I needed to ensure I had support in the country where I was researching. I contacted the director of the Unite for Sight partner eye clinic in Chennai and confirmed that my study would be feasible to pursue in 8 weeks along with my responsibilities as a Unite for Sight volunteer.

What did you find most rewarding about pursuing research?

The most rewarding aspect of research is the far-reaching impact the results will have. The results of the study, although focused on informed consent for cataract surgery, can be applied to many other fields and can aid in effectively communicating with vulnerable populations in multiple contexts. The educational posters are now being used in the eye camps in Chennai to help inform patients, and are also being integrated into the Unite for Sight partner eye clinics worldwide. The study was successful in improving patient care for extremely poor . . . people, which is ultimately the most rewarding result.

What were your greatest obstacles as a researcher?

Some obstacles that came up were in regards to working with a foreign population that had special educational needs. For instance, I initially intended on using a multiple-choice questionnaire, but after running a pilot of the study, there was a need to switch to a true/false format, the approval for which was coordinated through the Human Subjects Committee of Yale University, due to problems of patient comprehension. Also, the language barrier was difficult to overcome and the aid of a translator was used to read questions aloud to patients.

What advice do you have for volunteers developing research studies?

I would advise fellow volunteers to begin working on the design of the study several months before going into the field. I strongly recommend finding a faculty adviser that can help guide and advise you throughout. Make sure to ensure you have the support needed in the foreign country by contacting Unite For Sight's U.S. office and the Unite for Sight director of the program where you will be working. Also, keep in mind the responsibilities you will have as a volunteer, and make sure your project is not going to conflict with these duties and will instead complement them and produce beneficial results.