Design: A mixed-methods prospective pre–post study over two dedicated laparoscopic skills simulation workshops

Setting: Laparoscopic simulation curriculum conducted at St. Michael's Hospital in Toronto, Canada with residents using box laparoscopic simulators

Patients or Participants: Nine (all) first year Obstetrics and Gynaecology residents at the University of Toronto

Interventions: A new surgical ergonomics didactic lecture and one-on-one haptic teaching curriculum

Measurements and Main Results:

Paired sample t-test were used to compare pre- and post- survey scores. Posture was evaluated using the Rapid Upper Limb Assessment (RULA) tool.

Of the nine participating residents, the average age was 27.33 years, 8/9 (88.9%) identified as cis-female, and 8/9 (88.9%) were in post-graduate year one. Zero (0%) and 4/9 (44.4%) reported exposure to any formal or informal ergonomics education in residency thus far, respectively.

When comparing pre-and post-intervention survey data, residents identified improved knowledge of surgical ergonomics, increased awareness of available guidelines, improved perception of the importance of ergonomics training in residency, and stronger belief that time should be allocated to surgical ergonomics training in residency (p<0.001, p=0.020, p=0.034, and p=0.011, respectively).

On average RULA scores improved following intervention with borderline significance (4.00 ± 0.71 vs, 3.56 ± 0.53, p=0.052), including 1 point improvement for the majority of participants (n=5/9, 55.6%), no change for 3 residents (33.3%) and only one subject with worsening posture (11.1%).

Conclusion:

Lecture-based and hands-on ergonomic training was an effective strategy to improve posture, improve awareness and knowledge of surgical ergonomics, and change attitudes regarding the importance of surgical ergonomics education during residency. Future studies should expand ergonomics education to all residency years and review whether this formal curriculum confers long-lasting change in a learner’s ergonomics.