Sex differences impact ergonomic endoscopic training for gastroenterology fellows

Abstract

Background and AimsEndoscopic related injuries (ERI) for gastroenterologists are common and can impact longevity of an endoscopic career. This study examines sex differences in the prevalence of ERIs and ergonomic training during gastroenterology (GI) fellowship. MethodsA 56-item anonymous survey was sent to 709 general and advanced endoscopy GI fellows at 73 United States (US) training programs between May and June 2022. Demographic information was collected along with questions related to endoscopic environment, ergonomic instruction, technique, equipment availability, and ergonomic knowledge. Responses of female and male GI fellows were compared using Chi-square and Fisher exact tests. ResultsOf the 236 respondents (response rate 33.9%), 113 (44.5%) were female and 123 (52.1%) were male. Female fellows reported on average smaller hand sizes and shorter heights. More female fellows reported endoscopic equipment was not ergonomically optimized for their use. Additionally, more female fellows voiced preference for same gender teachers and access to dial extenders and well-fitting lead aprons. High rates of post-endoscopy pain were reported by both sexes, with significantly more females experiencing neck and shoulder pain. Trainees of both sexes demonstrated poor ergonomic awareness with an average score of 68% on 5-point knowledge-based assessment. ConclusionPhysical differences exist between male and female trainees, and current endoscopic equipment may not be optimized for smaller hand sizes. This study highlights the urgent need for formal ergonomic training for trainees and trainers with consideration of stature and hand size to enhance safety, comfort, and equity in the training and practice of endoscopy.