title: "I got it on Ebay!": cost-effective approach to surgical skills laboratories.
abstract: Surgical education is witnessing a surge in the use of simulation. However, implementation of simulation is often cost-prohibitive. Online shopping offers a low budget alternative. The aim of this study was to implement cost-effective skills laboratories and analyze online versus manufacturers' prices to evaluate for savings.
  
  
  
  Four skills laboratories were designed for the surgery clerkship from July 2014 to June 2015. Skills laboratories were implemented using hand-built simulation and instruments purchased online. Trademarked simulation was priced online and instruments priced from a manufacturer. Costs were compiled, and a descriptive cost analysis of online and manufacturers' prices was performed. Learners rated their level of satisfaction for all educational activities, and levels of satisfaction were compared.
  
  
  
  A total of 119 third-year medical students participated. Supply lists and costs were compiled for each laboratory. A descriptive cost analysis of online and manufacturers' prices showed online prices were substantially lower than manufacturers, with a per laboratory savings of: $1779.26 (suturing), $1752.52 (chest tube), $2448.52 (anastomosis), and $1891.64 (laparoscopic), resulting in a year 1 savings of $47,285. Mean student satisfaction scores for the skills laboratories were 4.32, with statistical significance compared to live lectures at 2.96 (P < 0.05) and small group activities at 3.67 (P < 0.05).
  
  
  
  A cost-effective approach for implementation of skills laboratories showed substantial savings. By using hand-built simulation boxes and online resources to purchase surgical equipment, surgical educators overcome financial obstacles limiting the use of simulation and provide learning opportunities that medical students perceive as beneficial.
authors.affiliation: College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Ethan
authors.initials: E
authors.lastname: Schneider
authors.affiliation: Division of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Schenarts
authors.affiliation: Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Valerie
authors.initials: V
authors.lastname: Shostrom
authors.affiliation: Division of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Kimberly D
authors.initials: KD
authors.lastname: Schenarts
authors.affiliation: Division of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska. Electronic address: charity.evans@unmc.edu.
authors.forename: Charity H
authors.initials: CH
authors.lastname: Evans
mesh_terms: D002982:Clinical Clerkship / Q000191:economics* / Q000379:methods*; D003132:Commerce / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D013502:General Surgery / Q000191:economics / Q000193:education*; D006801:Humans; D020407:Internet; D010535:Laparoscopy / Q000191:economics / Q000193:education / Q000295:instrumentation; D010549:Personal Satisfaction; D000066908:Simulation Training / Q000191:economics*; D014481:United States
keywords: Cost-effective; Hand built; Medical education; Online; Simulation; Surgical skills laboratory