Challenges Experienced by Surgical Trainees With Small Hand Size: A Multi-Institutional Mixed Methods Study

IF 2.2 3区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Surgical Education Pub Date : 2026-01-01 Epub Date: 2025-11-19 DOI:10.1016/j.jsurg.2025.103727

Rebecca Tang MD , Michael Kochis MD, EdM , Dandan Chen PhD , Rachael Acker MD , Julia Kasmirski MD , Jonathan Greer MD , Brenessa Lindeman MD, MEHP , Abbey Fingeret MD, MHPTT , Roy Phitayakorn MD, MHPE

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引用次数: 0

Abstract

Objectives

Surgeons with smaller hand size experience ergonomic mismatch related to instrument design. We aim to describe the impact of these ergonomic disadvantages on the educational experiences of surgical trainees and identify strategies for mitigating such challenges.

Design

A survey queried demographics, hand size, and perceived impact of hand size on completing operative tasks. Results were summarized with descriptive statistics, and perceived impact of hand size compared between residents with and without small hand size (SHS, defined as glove ≤6.5) via t-test. A subset of respondents including trainees with SHS and their educators completed semi-structured interviews further investigating their perspectives. Interview transcripts were analyzed using an inductive thematic approach.

Setting

Three large academic medical centers.

Participants

One hundred residents (51.0% response rate) and 123 attendings (49.6%) completed the survey. Eleven residents and 8 attendings were interviewed.

Results

Residents with SHS noticed an impact of hand size on completing operative tasks 50.0% of the time, compared to 15.5% in residents without SHS (p < 0.001). Main themes surrounding the challenges facing surgical trainees with SHS included: (1) Technical challenges related to instrument handling, (2) Slower skill acquisition particularly in early years of training, (3) Negative psychological consequences for trainees including self-doubt and fear of judgment, (4) Negative impact on resident evaluations and operative autonomy, (5) Inadequate support from educators, and (6) Overcoming challenges through technical workarounds, deliberate practice, self-advocacy, and role-modeling.

Conclusions

Surgical trainees with SHS face challenges that significantly impact their learning environment. Developing and practicing technical workarounds, self-advocating, and identifying role models allows trainees with SHS to overcome these challenges and become excellent surgeons. This study highlights the ongoing need for faculty development to increase awareness of this issue and improved instrument design for this growing sector of the surgical workforce.

查看原文本刊更多论文

手部小的外科培训生所面临的挑战：一项多机构混合方法研究。

目的：手尺寸较小的外科医生经历与器械设计相关的人体工程学不匹配。我们的目的是描述这些人体工程学的缺点对外科受训者的教育经历的影响，并确定减轻这些挑战的策略。设计：一项调查询问了人口统计学，手的大小，以及手的大小对完成操作任务的感知影响。对结果进行描述性统计总结，并通过t检验比较小手尺寸（SHS，定义为手套≤6.5）和非小手尺寸居民对手尺寸的感知影响。一部分受访者，包括SHS学员及其教育工作者完成了半结构化访谈，进一步调查了他们的观点。访谈记录分析使用归纳主题的方法。环境：三个大型学术医疗中心。调查对象：100名住院医师（51.0%）和123名主治医师（49.6%）完成了调查。采访了11名住院医生和8名主治医生。结果：有SHS的住院医生注意到手的大小对完成手术任务的影响的比例为50.0%，而没有SHS的住院医生注意到这一比例为15.5% （p ）结论：有SHS的外科实习生面临的挑战显著影响了他们的学习环境。开发和实践技术解决方案，自我倡导和确定榜样，使SHS学员能够克服这些挑战，成为优秀的外科医生。这项研究强调了教师发展的持续需求，以提高对这一问题的认识，并为这一不断增长的外科劳动力部门改进仪器设计。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Education EDUCATION, SCIENTIFIC DISCIPLINES-SURGERY

CiteScore

5.60

自引率

10.30%

发文量

261

审稿时长

48 days

期刊介绍： The Journal of Surgical Education (JSE) is dedicated to advancing the field of surgical education through original research. The journal publishes research articles in all surgical disciplines on topics relative to the education of surgical students, residents, and fellows, as well as practicing surgeons. Our readers look to JSE for timely, innovative research findings from the international surgical education community. As the official journal of the Association of Program Directors in Surgery (APDS), JSE publishes the proceedings of the annual APDS meeting held during Surgery Education Week.