Bickerton Robert, Goatly Giles, Bowbrick Ginny
East Sussex Healthcare NHS Trust, Hastings, United Kingdom.
East Sussex Healthcare NHS Trust, Hastings, United Kingdom.
J Surg Educ. 2025 Feb;82(2):103405. doi: 10.1016/j.jsurg.2024.103405. Epub 2024 Dec 30.
Work-related injuries are common among surgeons with up to 70 % being found to report difficulties. Given the extension expected to career longevity for current trainees, injury prevention is more important than ever. However, ergonomics education for surgical trainees in the UK is deficient. We aimed to gauge whether current trainees in Kent, Surrey and Sussex (KSS) experience pain whilst operating and what strategies, if any, they utilise.
DESIGN, SETTING AND PARTICIPANTS: A questionnaire was distributed to trainees in the KSS School of Surgery collecting data on pain related to operating and pain management strategies. Participants discussed their experiences of operating-related pain in a focus group.
75 trainees across the KSS region responded. Mean age was 32 years (range 26-42) and median training level was ST4. General surgery (n = 22), orthopaedics (n = 19) and urology (n = 13) were the most prevalent specialties. All trainees reported musculoskeletal pain attributed to operating, with 36 % (n = 27) experiencing pain "frequently" or "always". 69 % (n = 52) found this pain "sometimes", "frequently" or "always" distracted them whilst operating. The most common sites for pain were the lower back (73 %), neck (49.3 %), upper back (38.7 %) and shoulders (37.3 %). No participants had received formal ergonomics training and the majority (86.7 %) had not discussed pain with their supervisors. The focus group identified a culture of enduring pain without complaint and a reluctance to discuss it with mentors.
Musculoskeletal pain from operating was found to be a common issue in this cohort with the majority reporting distraction while operating. Ergonomics is not currently addressed by any formal training programmes and we have recommended a regional training initiative for trainees in KSS to address and prevent musculoskeletal injuries.
工作相关损伤在外科医生中很常见,高达70%的外科医生表示有相关困扰。鉴于当前外科住院医师的职业生涯预期延长,预防损伤比以往任何时候都更加重要。然而,英国对外科住院医师的人体工程学教育存在不足。我们旨在评估肯特、萨里和苏塞克斯(KSS)地区的当前住院医师在手术时是否经历疼痛,以及他们采用了哪些策略(如果有的话)。
设计、地点和参与者:向KSS外科学校的住院医师发放了一份问卷,收集与手术相关疼痛及疼痛管理策略的数据。参与者在一个焦点小组中讨论了他们与手术相关疼痛的经历。
KSS地区的75名住院医师做出了回应。平均年龄为32岁(范围26 - 42岁),中位培训水平为ST4。普通外科(n = 22)、骨科(n = 19)和泌尿外科(n = 13)是最常见的专业。所有住院医师都报告了因手术导致的肌肉骨骼疼痛,其中36%(n = 27)“经常”或“总是”经历疼痛。69%(n = 52)发现这种疼痛在手术时“有时”“经常”或“总是”会分散他们的注意力。最常见的疼痛部位是下背部(73%)、颈部(49.3%)、上背部(38.7%)和肩部(37.3%)。没有参与者接受过正式的人体工程学培训,大多数(86.7%)没有与他们的上级讨论过疼痛问题。焦点小组发现存在一种默默忍受疼痛而不抱怨的文化,并且不愿意与导师讨论疼痛问题。
在这个队列中,手术引起的肌肉骨骼疼痛是一个常见问题,大多数人报告在手术时有注意力分散的情况。目前任何正式培训项目都未涉及人体工程学内容,我们建议为KSS地区的住院医师开展一项区域培训计划,以解决和预防肌肉骨骼损伤。