Female Surgical Ergonomics in Otolaryngology: A Qualitative Study

Abstract

ObjectiveTo explore the surgical ergonomic challenges experienced by women in otolaryngology, identify specific equipment that is ergonomically challenging, and assess the impact of suboptimal ergonomics on female otolaryngologists.MethodsWe performed a qualitative study using an interpretive framework rooted in grounded theory. We performed semi‐structured qualitative interviews of 14 female otolaryngologists from nine institutions at various stages in training and across subspecialties. Interviews were independently analyzed by thematic content analysis by two researchers and inter‐rater reliability was assessed via Cohen's kappa. Differing opinions were reconciled via discussion.ResultsParticipants noted difficulties with equipment including microscopes, chairs, step stools, and tables as well as difficulty using larger surgical instruments, preference for smaller instruments, frustration with lack of smaller instruments, and a desire for a larger spectrum of instrument sizes. Participants reported neck, hand, and back pain associated with operating. Participants suggested modifications to the operative environment, including a wider variety of instrument sizes, adjustable instruments, and more focus and attention on ergonomic issues and the range of surgeon physiques. Participants felt that optimizing their operating room set‐up was an additional burden on them, and that lack of inclusive instrumentation affected their sense of belonging. Participants emphasized positive stories of mentorship and empowerment from peers and superiors of all genders.ConclusionFemale otolaryngologists face unique ergonomic challenges. As the otolaryngology workforce becomes increasingly diverse, it is important to address the needs of a diverse set of physiques to avoid inadvertently disadvantaging certain individuals.Level of EvidenceN/A Laryngoscope, 2023

Female Surgical Ergonomics in Otolaryngology: A National Survey Study

“…For that reason, our group recently conducted a qualitative interview study examining the perspectives of female surgeons on surgical ergonomics. 14 Our participants frequently reported difficulty with a variety of surgical instruments and operating room equipment, as well as frustration with the lack of a diversity of instrument sizes available, difficulties with operating room set up due to their size, and frequently having to ask operating room staff for assistance. While these findings were meaningful, the small sample size limited generalization to a broader population.…”

“…A prior study by our group examined the ergonomics of female otolaryngologists by qualitatively analyzing open-ended interviews. 14 We found high rates of ergonomic challenges, exacerbated by specific instruments and equipment, as well as frequent work-related pain and cultural challenges associated with ergonomics. While these interviews helped us gain in-depth insight into the ergonomic difficulties experienced by female otolaryngologists, we had a limited number of participants due to the qualitative study design.…”

“…Our group previously explored the surgical ergonomic difficulties experienced by women in otolaryngology in a qualitative study. 14 The themes identified were used to develop a 58-item questionnaire (Supplemental 1, available online), designed to assess the ergonomic challenges experienced by female otolaryngologists. Demographic and physical stature information was collected, as well as questions regarding difficulties using surgical instruments and equipment, pain associated with operating, effects of ergonomics on career plans, and cultural aspects of ergonomic challenges.…”

Impact of Ergonomics on Muscle Fatigue During Surgical Drilling Using Surface Electromyography

“…[20][21][22] A recent qualitative study highlighted that female surgeons face several unique challenges, often derived from male-oriented equipment design and environmental considerations. 23 As the field of otolaryngology strives to become more diverse, gender-inclusive equipment design and education of all stakeholders may help combat disparities in surgical ergonomics.…”