The Ergonomic Behaviors Evaluation Tool (EBET) based on social cognitive theory for the assembly line workers: development and psychometric assessment.

BACKGROUND: Ergonomic behaviors play a crucial role in preventing work-related musculoskeletal disorders (WMSDs). To measure these behaviors, this research aimed to develop and evaluate an ergonomic behaviors tool (EBET) based on the Social Cognitive Theory (SCT) among women workers on assembly lines (WwAL). METHODS: The study was conducted from December 2022 to January 2023 with a focus on the psychometric assessment of EBET. Initially, a literature review and interviews were carried out to identify crucial concepts and primary items. The questionnaire's validity was evaluated using the Content Validity Ratio (CVR) and the Content Validity Index (CVI). To determine the domains of the tool, construct validity was examined by administering the items to 270 eligible women. The reliability of the tool was assessed using McDonald's Omega coefficient. RESULTS: From a total of 67 primary items, 50 were confirmed. The study demonstrated good validity with CVR = 0.92 and CVI = 0.97, along with reliable results indicated by McDonald's Omega coefficient of 0.74. The exploratory factor analysis (EFA) revealed ten distinct dimensions: outcome expectations, outcome expectancies, normative beliefs, perceived barriers, social support, observational learning, reinforcement, behavioral skills, self-efficacy, and intention. Together, these dimensions accounted for 66.25% of the variance in the data. Additionally, the confirmatory factor analysis results supported the presence of these ten constructs and demonstrated a satisfactory fit. CONCLUSIONS: EBET is a dependable and valid instrument for evaluating the ergonomic behaviors of workers, utilizing the principles of SCT. Researchers can employ EBET to gather data and implement suitable training interventions to enhance ergonomic behavior among WwAL. However, it is crucial to recognize that EBET may not encompass all facets of ergonomic behaviors. Therefore, it is imperative for future research to prioritize the evaluation of EBET's suitability among diverse worker populations and to consider additional dimensions of ergonomics to ensure its wider applicability and effectiveness.

Assessment of Surgeons' Stress Levels with Digital Sensors during Robot-Assisted Surgery: An Experimental Study.

Robot-Assisted Minimally Invasive Surgery (RAMIS) marks a paradigm shift in surgical procedures, enhancing precision and ergonomics. Concurrently it introduces complex stress dynamics and ergonomic challenges regarding the human-robot interface and interaction. This study explores the stress-related aspects of RAMIS, using the da Vinci XI Surgical System and the Sea Spikes model as a standard skill training phantom to establish a link between technological advancement and human factors in RAMIS environments. By employing different physiological and kinematic sensors for heart rate variability, hand movement tracking, and posture analysis, this research aims to develop a framework for quantifying the stress and ergonomic loads applied to surgeons. Preliminary findings reveal significant correlations between stress levels and several of the skill-related metrics measured by external sensors or the SURG-TLX questionnaire. Furthermore, early analysis of this preliminary dataset suggests the potential benefits of applying machine learning for surgeon skill classification and stress analysis. This paper presents the initial findings, identified correlations, and the lessons learned from the clinical setup, aiming to lay down the cornerstones for wider studies in the fields of clinical situation awareness and attention computing.

Assessment and evaluation of work-related musculoskeletal disorders among nuclear medicine professionals in India: A cross-sectional study.

BACKGROUND: Musculoskeletal disorders (MSDs) are a severe occupational health issue among medical radiation practitioners. It is mostly linked to personal protective wear, working posture, tools employed and ergonomics. OBJECTIVE: To assess and evaluate the musculoskeletal disorders among nuclear medicine professionals (NMP) in India. METHODS: An online survey was distributed to 455 NMP throughout India between November 2021 and March 2022 covering the demographic characteristics and questions for evaluation of musculoskeletal symptoms using the Standardized Nordic Musculoskeletal Questionnaire (NMQ). Participants with any pre-existing musculoskeletal disorder or trauma were excluded. Descriptive statistics summarized the data from the demographics, discomfort, aches and work-related musculoskeletal injuries. Chi-square test was used to examine the association between the obtained values. RESULTS: 91 out of 124 respondents were included based on the inclusion and exclusion criteria. Results shows that there is a significant association between the height of the individual and neck pain, body mass index and elbows pain, age and low back pain, experience in the current work and upper back pain, the weight of the individual and knee pain, use of mobile lead screens and shoulder pain, use of gonad shield, trouble in the ankles and use of lead screens, and QC phantoms for gamma camera / PET and wrists/hands pain. CONCLUSION: Work-related musculoskeletal disorders among NMP are resulting from factors of individual demographic variables (such as age, height, weight, body mass index), years of experience at the current workplace and of using instruments in their work area.

Equivalent weight: Application of the assessment method on real task conducted by railway workers wearing a back support exoskeleton.

Commonly used risk indexes, such as the NIOSH Lifting Index, do not capture the effect of exoskeletons. This makes it difficult for Health and Safety professionals to rigorously assess the benefit of such devices. The community requires a simple method to assess the effectiveness of back-support exoskeleton's (BSE) in possibly reducing ergonomic risk. The method introduced in this work is termed "Equivalent Weight" (EqW) and it proposes an interpretation of the effect built on the benefit delivered through reduced activation of the erector spinae (ES). This manifests itself as an apparent reduction of the lifted load perceived by the wearer. This work presents a pilot study where a practical application of the EqW method is used to assess the ergonomic risk in manual material handling (MMH) when using a back support exoskeleton (StreamEXO). The results are assessed by combining observational measurements from on-site testing with five different workers and quantitative measures of the muscle activity reduction achieved during laboratory evaluation with ten workers. These results will show that when lifting, lowering, and carrying a 19 kg load the StreamEXO can reduce risk by up to two levels (from "high" to "low") in the target sub-tasks. The Lifting index (LI) was reduced up to 64% when examining specific sub-tasks and the worker's movement conduction.

Evidence map on burnout syndrome in higher education teachers and its relationship with ergonomic and biopsychosocial factors: a scoping review.

Objectives. This study aimed to map the evidence on burnout syndrome in higher education teachers and its relationship with ergonomic and biopsychosocial factors. Methods. We performed a scoping review of articles published up to 2021, extracting the location, study design, sample characteristics and assessment methods, and investigated ergonomic and biopsychosocial factors. Results. Eighteen studies were found in 12 countries, and most used a cross-sectional design (n = 17/18, 94%). The Maslach burnout inventory was the most used assessment method (n = 9, 50%). There is a consensus that burnout syndrome in higher education teachers requires more attention, as it can be related to physical, mental and social factors. Conclusions. In the professional environment, physical ergonomic characteristics or those related to work organization deserve greater attention, as well as psychosocial factors, as they are strongly associated with burnout syndrome.

Effectiveness of and preference for a picture-based home office ergonomics assessment compared to a traditional in-person office ergonomics assessment: A case study from a Canadian University during the COVID-19 pandemic.

During the COVID-19 pandemic, telework best practices decreased in importance compared to the need for social distancing. It is important that ergonomics assessments for home office workstations are equally as effective as assessment for traditional offices to maintain teleworker wellbeing. The purpose of this case study is to compare a remote, picture-based, home office assessment to a traditional, in-person, office assessment for employees of one Canadian University. Intraclass Correlation Coefficients (ICCs) and Bland-Altman Analyses (BAAs) revealed that the two methods provide repeatable results, with good agreement. Feedback from the participants suggested that picture-based assessments were as effective as in-person assessments; but that picture-based assessments could be improved with video conferencing to discuss findings and ask follow-up questions. Participants found value in remote assessments and, while they preferred in-person assessments, picture-based assessments are suitable when needed as they allow for many assessments to be completed without violating social distancing restrictions.

simMACT, a Software Demonstrator to Improve Maximum Actuation Joint Torques Simulation for Ergonomics Assessment.

The maximum actuation joint torques that operators can perform at the workplace are essential parameters for biomechanical risk assessment. However, workstation designers generally only have at their disposal the imprecise and sparse estimates of these quantities provided with digital manikin digital human model (DHM) software. For instance, such tools consider only static postures and ignore important specificities of the human musculoskeletal system such as interjoints couplings. To alleviate the weaknesses of existing approaches implemented in digital human modeling tools relying on torque databases, this paper describes a methodology based on a class of polytopes called zonotopes and musculoskeletal simulation to assess maximum actuation torques. It has two main advantages, the ability to estimate maximum joint torques for any posture and taking into account musculoskeletal specificities unlike existing digital human modeling tools. As a case study, it also compares simulated maximum actuation torques to those recorded during an experiment described in the literature, focusing on an isometric task of the upper limb. This simulation has led to similar or smaller errors than DHM software tools. Hence, this methodology may help in interpreting interjoint couplings, choosing appropriate mathematical models or design experimental protocols. It may also be implemented in DHM software to provide designers with more comprehensive and more reliable data.

Factors Affecting Perioperative Nurse Adherence to Ergonomic Safety Measures.

AORN has identified safety risks unique to the perioperative setting and has developed ergonomic safety measures to help prevent musculoskeletal injuries and disorders. Little is known about adherence to these safety measures or the perceived barriers and facilitators to adherence. This study used a cross-sectional survey to determine the prevalence of pain and occurrence of musculoskeletal injuries and disorders. We asked perioperative staff members about their perceived barriers and facilitators to adherence with safety measures. A total of 155 perioperative nurses in one health system completed the online survey (55% response rate). Most (93%) had experienced at least one musculoskeletal injury or disorder or related pain. Years worked as a perioperative nurse and having neck pain were associated with safety measure adherence. The most reported barrier to safety measure adherence was inadequate staffing. Study findings highlight the need for increased attention to the physical workload demands in the perioperative setting.

Transparency as a Means to Analyse the Impact of Inertial Sensors on Users during the Occupational Ergonomic Assessment: A Systematic Review.

The literature has yielded promising data over the past decade regarding the use of inertial sensors for the analysis of occupational ergonomics. However, despite their significant advantages (e.g., portability, lightness, low cost, etc.), their widespread implementation in the actual workplace has not yet been realized, possibly due to their discomfort or potential alteration of the worker's behaviour. This systematic review has two main objectives: (i) to synthesize and evaluate studies that have employed inertial sensors in ergonomic analysis based on the RULA method; and (ii) to propose an evaluation system for the transparency of this technology to the user as a potential factor that could influence the behaviour and/or movements of the worker. A search was conducted on the Web of Science and Scopus databases. The studies were summarized and categorized based on the type of industry, objective, type and number of sensors used, body parts analysed, combination (or not) with other technologies, real or controlled environment, and transparency. A total of 17 studies were included in this review. The Xsens MVN system was the most widely used in this review, and the majority of studies were classified with a moderate level of transparency. It is noteworthy, however, that there is a limited and worrisome number of studies conducted in uncontrolled real environments.

Gender equity in surgical instruments: ergonomics of ring-handled forceps.

INTRODUCTION: Female surgeons have ergonomic issues with commercialized instruments tailored for male surgeons. The purpose of this study was to identify satisfaction levels and ergonomic problems of female surgeons while using laparoscopic forceps with ring-handles and suggest improvement measures. MATERIAL AND METHODS: A questionnaire was sent to 19,405 members of the Japanese Society of Gastroenterological Surgery via email between 1 August 2022 and 30 September 2022. It included demographic information and specific questions regarding the use of laparoscopic forceps with ring- handles (ergonomic evaluation, influence of the negative aspects of laparoscopic forceps during surgery, physical discomfort in the hands and fingers, degree of satisfaction, and handle size). RESULTS: Valid responses were received from 1,030 respondents (131 female and 899 male surgeons). The ergonomics of the laparoscopic forceps with ring-handles were rated lower by female surgeons in all ten categories (all p value < 0.05). They also reported a negative impact on surgical manipulation and discomfort to their hands and fingers. CONCLUSIONS: Female surgeons had a wide variety of ergonomic problems when using laparoscopic forceps with ring-handles, and showed lower levels of satisfaction. Developing a different model tailored to female surgeons with smaller hands and a weaker grip could be a viable solution.

Cross-cultural adaptation and reliability assessment of the Indonesian version of the Computer Workstation Ergonomics: Self-Assessment Checklist.

BACKGROUND: Prolonged use of computer devices can have adverse health effects, but these can be mitigated by setting up computer workstations according to ergonomic principles. The Computer Workstation Ergonomics: Self-Assessment Checklist can guide workers in implementing these principles. However, the checklist is only available in English, which may reduce the accuracy of the instrument when used by non-English speakers, including Indonesians. OBJECTIVE: The objective of this study was to cross-culturally adapt the Computer Workstation Ergonomics: Self-Assessment Checklist for use in Indonesia. Additionally, a reliability assessment was conducted on the adapted checklist. METHODS: This study followed a six-stage cross-cultural adaptation process, including translation, synthesis of translation, back translation, expert committee review, pretesting, and documentation submission. The final version of the adapted checklist underwent testing for intra-rater reliability, inter-rater reliability, and internal consistency. RESULTS: The cross-cultural adaptation process resulted in an Indonesian version of the Computer Workstation Ergonomics: Self-Assessment Checklist. Furthermore, the Krippendorff's alpha values for the intra-rater and inter-rater reliability of the adapted checklist ranged from 0.59 to 0.78 (mean = 0.70) and 0.20 to 0.82 (mean = 0.56), respectively. CONCLUSION: The study produced an Indonesian version of the Computer Workstation Ergonomics: Self-Assessment Checklist that had an adequate reliability. The adapted checklist can serve as a practical tool for evaluating and improving computer workstations in Indonesia.

Assessment of musculoskeletal pain and surgical ergonomic parameters among members of the American Society of Pediatric Otolaryngology.

OBJECTIVES: To assess rates of self-reported work-related pain and knowledge of ergonomic principles among fellowship trained pediatric otolaryngologists within the American Society of Pediatric Otolaryngology (ASPO). We hypothesized that pediatric otolaryngologists experience rates of musculoskeletal pain and injury similar to what has been reported among adult otolaryngologists and other surgical subspecialties. METHODS: An IRB-approved survey was distributed to members of ASPO through email listserv. Collected variables included surgeon demographic information, practice settings, surgical volume, procedure types, work-related musculoskeletal pain-related metrics, modifying factors, and knowledge/attitudes on surgical ergonomics. RESULTS: A total of 685 ASPO members were approached via email, of which 435 opened the survey email and 118 attending pediatric otolaryngologists completed the survey (response rate 27%). In all, 78% of respondents reported current or prior pain and/or injury attributed to performing surgery, 20% higher than that reported in the previous ergonomics survey of ASPO members in 2012. The most affected areas were neck/cervical spine (63%), shoulders/arms (44%), lower back/lumbar spine (36%), and hands/wrist (31%). Half of the respondents were diagnosed with musculoskeletal condition(s) attributed to performing surgery. Two-thirds required treatment (62% pharmacologic only, 9% pharmacologic and surgical intervention) for their work-related pain. Leveraging intermittent pauses during surgical procedures to adjust body position was the most reported method of addressing pain in the operating room. Only 21% report ever having received ergonomic training during their training or career. CONCLUSION: Musculoskeletal pain associated with performing pediatric otolaryngology procedures is highly prevalent and has not attenuated despite increased awareness of surgical ergonomics. Results from this study underscore the need to develop standardized surgical ergonomics curricula for pediatric otolaryngologists and trainees.

Sex differences impact ergonomic endoscopic training for gastroenterology fellows.

BACKGROUND AND AIMS: Endoscopic-related injuries (ERIs) 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 fellowship. METHODS: A 56-item anonymous survey was sent to 709 general and advanced endoscopy gastroenterology fellows at 73 U.S. 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 gastroenterology fellows were compared using χ2 and Fisher exact tests. RESULTS: Of the 236 respondents (response rate, 33.9%), 113 (44.5%) were women and 123 (52.1%) were men. 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 postendoscopy pain were reported by both sexes, with significantly more women experiencing neck and shoulder pain. Trainees of both sexes demonstrated poor ergonomic awareness with an average score of 68% on a 5-point knowledge-based assessment. CONCLUSIONS: Physical 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.

Machine learning approach to determine the decision rules in ergonomic assessment of working posture in sewing machine operators.

INTRODUCTION: There are some inherent problems with the use of observation methods in the ergonomic assessment of working posture, namely the stability and precision of the measurements. This study aims to use a machine learning (ML) approach to avoid the subjectivity bias of observational methods in ergonomic assessments and further identify risk patterns for work-related musculoskeletal disorders (WMSDs) among sewing machine operators. METHODS: We proposed a decision tree analysis scheme for ergonomic assessment in working postures (DTAS-EAWP). First, DTAS-EAWP used computer vision-based technology to detect the body movement angles from the on-site working videos to generate a dataset of risk scores through the criteria of Rapid Entire Body Assessment (REBA) for sewing machine operators. Second, data mining techniques (WEKA) using the C4.5 algorithm were used to construct a representative decision tree (RDT) with paths of various risk levels, and attribute importance analysis was performed to determine the critical body segments for WMSDs. RESULTS: DTAS-EAWP was able to recognize 11,211 samples of continuous working postures in sewing machine operation and calculate the corresponding final REBA scores. A total of 13 decision rules were constructed in the RDT, with over 95% prediction accuracy and 83% path coverage, to depict the possible risk tendency in the working postures. Through RDT and attribute importance analysis, it was identified that the lower arm and the upper arms exhibited as critical segments that significantly increased the risk levels for WMSDs. CONCLUSIONS: This study demonstrates that ML approach with computer vision-based estimation and DT analysis are feasible for comprehensively exploring the decision rules in ergonomic assessment of working postures for risk prediction of WMSDs in sewing machine operators. PRACTICAL APPLICATIONS: This DTAS-EAWP can be applied in manufacturing industries to automatically analyze working postures and identify risk patterns of WMSDs, leading to the development of effectively preventive interventions.

Ergonomic risk assessment of working postures of nurses working in a medical faculty hospital with REBA and RULA methods.

The aim of the study is to reach objective results about the ergonomic risks of nurses' working postures not only by using questionnaires but also by using Rapid Entire Body Assessment (REBA) and Rapid Upper Limb Assessment (RULA) methods, which are risk assessment methods used in engineering fields. This study is a cross-sectional study. First of all, 383 nurses were evaluated with a survey. 91.4% of the nurses were women and 6.5% were men. Average age (female: 38.20; male: 31.5), average weight (female: 65.60 kg; male: 81.50 kg), average height (female: 162.7 cm; male: 176.80 cm) and average body mass index (female: 24.80; male: 26) were calculated. In the hospital, which we grouped into in the hospital, which we divided into eight workstations, the REBA and RULA scores of the three nurses working at each workstation were calculated and the average REBA and RULA scores of the workstations were determined. The percentage of those who experienced musculoskeletal pain in the last 1 year at each workstation and the mean REBA-RULA scores were as follows; ward (92%; 6.92-5.69), operating room (98%; 10-7), emergency department (100%; 6.08-5.33), outpatient clinic (75%; 5.5-5.16), intensive care (94%; 6.21-5.57), administrative affairs (94%; 5-5), laboratory (95%; 5.80-5.2) and interventional procedure (92%; 6.4-5.4). In these stations, the highest scores were seen in the operating room. In the questionnaire, 92.46% of the nurses reported having complaints in at least one part of the musculoskeletal system in the last year. The hospital weighted mean score was REBA 6.86 and RULA 5.71. When REBA and RULA measurements were evaluated, it was determined that the risk in the departments where the nurses worked was generally at the medium risk level. REBA and RULA scores indicate that ergonomic changes and adjustments should be made. For this determination, the risks of working postures should be determined with quantitative methods.

Ergonomic risk management process for safety and health at work.

Purpose: The paper aims to provide the main principles and practical aspects of the model, to present the process of identifying, determining the level, as well as assessing and managing occupational and ergonomic risks. Methods: To conduct the research, as well as to identify the influence of various dangerous factors related to the working posture, pace, rhythm of work performance, equipment and individual characteristics of the employee's health condition, methods of complex analysis and synthesis, formal and dialectical logic are used to study the essence of the concept of occupational and ergonomic risks. Additionally, induction and deduction methods are used to examine the cause-and-effect relationships between dangers, dangerous factors, dangerous event, and the severity of consequences to determine the level of occupational and ergonomic risks based on the improved bow-tie model. The proposed approach effectiveness is tested based on the assessment of occupational and ergonomic risks of forest workers (loggers) with the participation of five experts to identify dangerous factors and develop precautionary measures. Results: An algorithm for managing occupational and ergonomic risks has been developed, consisting of eleven steps, which can be divided into three steps: preparatory, main and documented. It has been determined that occupational and ergonomic risk is the probability of a dangerous event occurring due to employee's physical overload and its impact on the severity of damage to the employee's physical health. The level of occupational and ergonomic risk management is determined taking into account the probability (frequency), intensity and duration of physical overload, as well as the employee's adaptation index to physical overload and his/her health index. Conclusion: The novelty is the substantiation of the principles of occupational and ergonomic risk management, which are based on the bow-tie model and predict the impact on the probability and severity of consequences of a dangerous event, taking into account dangerous factors. Forms for drawing up occupational and ergonomic risk maps have been developed, in which it is necessary to consider interaction of occupational hazards and occupational-ergonomic risk - physical overload.

Implementation and Evaluation of a Curriculum for Ergonomics Training During GI Fellowship.

BACKGROUND AND AIMS: Training in ergonomics is either fragmented or lacking in most GI programs. There are limited real-world data on fellows' perceptions and change in practice after the delivery of a curriculum for ergonomics. We aim to implement a curriculum for endoscopy for our GI fellows and evaluate their response to the same. METHODS: We devised and implemented a curriculum with three components, delivered over 6 months for all GI fellows in an academic hospital center. These were one, a comprehensive, hour-long didactics session conducted by an experienced faculty member; two, an interactive session with a physical therapist; and three, provision of free resistance bands and compression stockings to fellows. We conducted a pre- and post-curriculum test. Data are presented as proportions and medians with interquartile range. RESULTS: We surveyed 23 fellows. At baseline, 13.6% (3) had sustained ERI during their training. Only 63.6% (14) of trainees reported confidence in being able to recognize signs and symptoms of ERI. Their median self-reported understanding of ergonomics was 3 on a Likert scale of 1-5, corresponding with "average understanding." The majority of trainees had never reviewed any material on ergonomics prior to this curriculum. In the post-test evaluation, the median self-reported understanding of ergonomics improved to 4, corresponding with "above average understanding." All fellows requested a repeat of the curriculum, either semi-annually or annually. CONCLUSION: Our data show a positive perception of trainees of a practical, reproducible, and low-cost curriculum for endoscopy incorporated during GI fellowship.

Cost and statistical efficiency of posture assessment by inclinometry and observation, exemplified by paper mill work.

Postures at work are paramount in ergonomics. They can be determined using observation and inclinometry in a variety of measurement scenarios that may differ both in costs associated with collecting and processing data, and in efficiency, i.e. the precision of the eventual outcome. The trade-off between cost and efficiency has rarely been addressed in research despite the obvious interest of obtaining precise data at low costs. Median trunk and upper arm inclination were determined for full shifts in 28 paper mill workers using both observation and inclinometry. Costs were estimated using comprehensive cost equations; and efficiency, i.e. the inverted standard deviation of the group mean, was assessed on basis of exposure variance components. Cost and efficiency were estimated in simulations of six sampling scenarios: two for inclinometry (sampling from one or three shifts) and four for observation (one or three observers rating one or three shifts). Each of the six scenarios was evaluated for 1 through 50 workers. Cost-efficiency relationships between the scenarios were intricate. As an example, inclinometry was always more cost-efficient than observation for trunk inclination, except for observation strategies involving only few workers; while for arm inclination, observation by three observers of one shift per worker outperformed inclinometry on three shifts up to a budget of €20000, after which inclinometry prevailed. At a budget of €10000, the best sampling scenario for arm inclination was 2.5 times more efficient than the worst. Arm inclination could be determined with better cost-efficiency than trunk inclination. Our study illustrates that the cost-efficiency of different posture measurement strategies can be assessed and compared using easily accessible diagrams. While the numeric examples in our study are specific to the investigated occupation, exposure variables, and sampling logistics, we believe that inclinometry will, in general, outperform observation. In any specific case, we recommend a thorough analysis, using the comparison procedure proposed in the present study, of feasible strategies for obtaining data, in order to arrive at an informed decision support.

Robotic-Assisted Surgery Training (RAST): Assessment of Surgeon Console Ergonomic Skills.

OBJECTIVE: The aim of this study was to evaluate the responsiveness of postgraduate year (PGY) general surgery residents (GSRs) to surgeon console ergonomics within the robotic-assisted surgery training (RAST) program. DESIGN: This was a prospective educational study. GSRs were prepared with a pretraining educational video. Faculty provided one-on-one resident hands-on training and testing. Nine proficiency criteria (emergency stop & recover; left side pod adjustments; touchpad controls; footswitch panel; energy control pedals; camera control & focus; arm swap; master & finger clutch; dual console settings control) were assessed with a 5-point Likert-scale. Responsiveness was defined as change in performance over time. The robotic platform was Da Vinci Xi (Intuitive Surgical, Sunnyvale, CA). The Dundee ready educational environment measure (DREEM) inventory was used by GSRs to assess the educational environment. SETTING: Tertiary care academic teaching institution. PARTICIPANTS: A total of 22 GSRs: 4 PGY 1, 4 PGY 2, 4 PGY 3, 5 PGY 4, 5 PGY 5. RESULTS: From June 2022 to March 2023 the hands-on console time decreased at testing when compared to baseline: median 39.0 (range 37-41) vs 20.1 (range 19-22) minutes, respectively. There was no difference in mean hands-on testing scores stratified by PGY: 4.85±0.4 PGY1; 4.98 ± 0.3 PGY2; 4.86 ± 0.4 PGY3, 4.88 ± 0.2 PGY4, and 4.91 ± 0.1 PGY5 (ANOVA test; p = 0.095). The overall DREEM score was 167.1 ± 16.9 with CAC = 0.908 (excellent internal consistency). CONCLUSIONS: Training in ergonomics on the surgeon console impacted the responsiveness of the GSRs with 51% console time reduction. There were no differences in hands-on testing scores among PGYs. Perception of the educational environment by the GSRs was high.

A participatory ergonomics intervention to re-design work and improve the musculoskeletal health of paramedics: protocol for a cluster randomised controlled trial.

BACKGROUND: In this paper, we present the protocol for a cluster randomised controlled trial to evaluate the effectiveness and implementation of a participative risk management intervention to address work-related musculoskeletal disorders (WMSDs). The aims of the study include to evaluate the implementation process and the impact of the intervention on work related musculoskeletal pain and discomfort and exposure to physical and psychosocial hazards in paramedics over a 12-month period. METHODS: The intervention in this study is to implement A Participative Hazard Identification and Risk Management (APHIRM) toolkit in an ambulance service. Eighteen work groups containing eligible participants (registered paramedics) will be randomised into the intervention or wait-list control arm in one of three rolling recruitment periods. The APHIRM toolkit survey will be offered at baseline and 12 months later, to all current eligible participants in each work group allocated to the trial. The intervention work groups will receive the remainder of the APHIRM toolkit procedures. Identifying data about individual participants will not be collected in the survey, to protect participant privacy and encourage participation. Changes in primary (musculoskeletal pain and discomfort) and secondary (exposure to physical and psychosocial hazards at work) outcomes measured in the survey will be analysed comparing the baseline and follow up response of the cluster. A process evaluation is included to analyse the implementation and associated barriers or facilitators. DISCUSSION: This study is important in providing a comprehensive approach which focusses on both physical and psychosocial hazards using worker participation, to address WMSDs, a well-known and significant problem for ambulance services. The effectiveness of the intervention in work groups will be rigorously evaluated. If significant positive results are observed, the intervention may be adopted in ambulance services, both nationally and internationally. TRIAL REGISTRATION: ISRCTN77150219. Registered 21 November 2021.