Accommodating Learners: An Adaptive Approach to Surgical Hand Preparation With Crutches

Accommodations for injured and disabled surgical providers have to balance an individual's needs with measures that ensure sterility requirements, patient and provider safety. The highly specialized nature of the surgical environment poses challenges when implementing changes in the operating room and literature is limited on adaptive surgical hand preparation techniques necessary to maximize a disabled medical student's active participation in their surgical clerkship.

This paper presents a detailed account of the development and implementation of an adaptive surgical hand preparation designed to address mobility needs, enabling a student's active participation and education in the surgical curriculum. This offers a framework for adapting traditional surgical hand preparation techniques for crutches consisting of essential requirements in terms of equipment and personnel, step-by-step guide for implementation, discussion of potential risks related to contamination and safety, and a discussion on future directions for further innovation.

An adaptive surgical hand preparation technique was necessary to sterilize forearm crutches for a third-year medical student with a physical disability to ensure accessibility in the operating room and equity in surgical clerkship and medical education. Successful use of this protocol, in over 40 surgical cases throughout an 8-week surgical clerkship, created opportunity for a disabled medical student to access the sterile operating table through collaboration and innovation in the operating room.

The adaptive hand preparation and sterile crutch cover solution was necessary for the student to assist in open, laparoscopic, and surgical procedures resulting in high clinical performance marks in the surgical clerkship. Beyond the individual benefit, this protocol promotes the importance of equity in medication education and encourages diversity through adaptive measures in the surgical field.

Designing an adaptive sterilization protocol for use of crutches in the operating room serves as an example of educational engineering and adaptable accessibility. The entire collaborative effort involving the medical student, university, surgical providers and operating room staff demonstrates the importance of teamwork in creating access in healthcare settings. Through learned experience, the authors provide insights for future directions for innovation, aiming to enhance access and inclusivity in medical education and surgical practice. This paper reflects on the broader implications of educational engineering and inclusive practices in healthcare.