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

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).

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.