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

Rebecca Tang1, Michael Kochis1, Dandan Chen1

  • 1Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.

Journal of Surgical Education
|November 19, 2025
PubMed
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This summary is machine-generated.

Surgical trainees with small hands face significant challenges impacting their training. Strategies like technical workarounds and self-advocacy help overcome these, but improved instrument design and faculty awareness are crucial.

Area of Science:

  • Surgical Education
  • Ergonomics in Medicine
  • Medical Device Design

Background:

  • Surgeons with smaller hand sizes experience ergonomic challenges due to instrument design.
  • These ergonomic disadvantages can negatively affect surgical trainees' educational experiences.

Purpose of the Study:

  • To describe the impact of ergonomic disadvantages on surgical trainees with small hands.
  • To identify strategies for mitigating these challenges in surgical education.

Main Methods:

  • A survey assessed hand size and its perceived impact on operative tasks among surgical residents and attendings.
  • Semi-structured interviews with trainees and educators provided further insights.
  • Statistical analysis (t-test) compared perceptions between residents with and without small hand size (SHS).
Keywords:
hand sizelearning environmentsurgical ergonomicstechnical skills teaching

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Main Results:

  • Residents with SHS reported task difficulties 50% of the time, versus 15.5% for those without (p < 0.001).
  • Key challenges included technical instrument handling, slower skill acquisition, psychological distress, and negative impacts on evaluations.
  • Trainees utilized workarounds, deliberate practice, self-advocacy, and role models to overcome difficulties.

Conclusions:

  • Small hand size presents significant challenges for surgical trainees' learning environment.
  • Technical workarounds, self-advocacy, and role models are effective coping strategies.
  • There is a need for faculty development and improved instrument design to support this demographic.