1
|
Sonnino RE, Sonnino VG. Handedness and Its Impact on a Career in Medicine. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:821-823. [PMID: 38691838 DOI: 10.1097/acm.0000000000005752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
ABSTRACT Left-handedness in a world of right lateral bias can be an invisible barrier both in everyday life as well as in medical career development, and throughout a medical career. Common everyday life actions, including screwing in lightbulbs, inserting a screw, or any action that requires a clockwise rotation, is designed for "righties," making life for "lefties" a challenge. Other examples include writing without a slant or without smudging. In medicine, the physical examination of a patient is taught using the right hand and standing on the right side of the patient, an awkward situation for left handers. Another major concern in medicine specifically, is handwriting-notoriously poor in lefties-impacting legibility in progress notes, prescriptions, and medical records. In surgery and other procedural specialties in particular, using instruments intended for right-handed individuals, including suturing and positioning at the operating room table, presents left-handed individuals with particular challenges. Left-handed medical students and residents are especially vulnerable, as they may feel uncomfortable requesting special accommodations for their "handedness." The significance and impact of handedness often go unrecognized, yet may play a substantial role in career choices: the difficulties of being left-handed may dissuade students from pursuing their desired career. Solutions are available, including using instruments designed for left-handers (or learning to use "righty" instruments), and positioning at the operating room or procedure table as preferred by the left-handed individual. These solutions often require a cooperative attitude by colleagues. The authors describe the significance of handedness, including their own personal experiences, and offer some solutions for left-handed individuals who struggle to adapt to a right-handed world.
Collapse
|
2
|
Alhussien A, Alamri A, Almjhad A, AlHumaizi A, Alsaleh S. Left-handedness in otolaryngology, who is right? Laryngoscope Investig Otolaryngol 2024; 9:e1264. [PMID: 38751690 PMCID: PMC11094766 DOI: 10.1002/lio2.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 03/27/2024] [Accepted: 04/28/2024] [Indexed: 05/18/2024] Open
Abstract
Objectives This study aimed to ascertain the prevalence of left-handedness (LH) among otolaryngology-head and neck surgery (ORLHN) practitioners, investigate dexterity's impact on LH trainees, and identify common patterns in their training to improve the training experience. Methods A web-based survey was distributed anonymously via email to members of the Saudi Otorhinolaryngology Society. The survey targeted ORLHN attending consultants, board-certified registrars, and current residents. It consisted of three sections: the first focused on the experience of attending consultants in training LH individuals, the second investigated common maneuvers employed by rhinologists, and the third explored the experiences and impacts reported by LH trainees. Results The study included 174 participants, and found a 13.2% LH prevalence among them. Rhinologists showed disparities, with 50% advising trainees to stand on the left side of the bed and use their left hand for the scope, whereas the other half asked otherwise. Additionally, 94.4% of the participants had not encountered any courses specifically tailored for LH trainees. Among LH trainees, 57% and 41% reported difficulties in learning and performing side-specific procedures such as functional endoscopic sinus surgery and endoscopic septoplasty, respectively, often attempting to switch to their nondominant hand, and feeling disadvantaged due to their laterality. Conclusions Left-handedness presents challenges for both LH trainees and their trainers in surgical specialties, particularly in ORLHN, in which specific positioning and instruments are crucial to gain access to the desired surgical field. Despite these challenges, there is insufficient support for LH individuals. We recommend encouraging LH trainees to openly disclose and discuss their left-handedness, provide them with mentors, establish standardized operating room setups and techniques, supply appropriate instruments, and demonstrate flexibility in accommodating their needs. Level of evidence Level 5.
Collapse
Affiliation(s)
- Ahmed Alhussien
- Otolaryngology—Head and Neck Surgery DepartmentCollege of Medicine, King Saud UniversityRiyadhSaudi Arabia
| | - Ahlam Alamri
- Otolaryngology—Head and Neck Surgery DepartmentKing Fahad Specialist HospitalTabukSaudi Arabia
| | | | - Abdulrahman AlHumaizi
- Otolaryngology—Head and Neck Surgery DepartmentKing Abdullah bin Abdulaziz University HospitalRiyadhSaudi Arabia
| | - Saad Alsaleh
- Otolaryngology—Head and Neck Surgery DepartmentCollege of Medicine, King Saud UniversityRiyadhSaudi Arabia
| |
Collapse
|
3
|
Powers AY, Rosenthal AE, Mackel CE, Riordan CP, Moses ZB. Left-Handed Palming of the Needle Driver: A Technical Report for Surgical Trainees. Cureus 2024; 16:e57931. [PMID: 38738035 PMCID: PMC11081786 DOI: 10.7759/cureus.57931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/14/2024] Open
Abstract
Left-handed surgical trainees are uniquely challenged when learning how to suture using standard needle drivers designed for right-handed individuals and often feel disadvantaged in comparison to their right-handed peers. "Palming," a suturing technique that improves suturing mechanics and efficiency, cannot be achieved in the standard manner using the left hand. This paper proposes a previously undescribed technique for palming using the left hand that provides many of the same benefits as standard palming methods using the right hand, potentially reducing a common source of inequity in surgical training.
Collapse
Affiliation(s)
- Andrew Y Powers
- Division of Neurosurgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Alex E Rosenthal
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Charles E Mackel
- Division of Neurosurgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Coleman P Riordan
- Division of Neurosurgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Ziev B Moses
- Division of Neurosurgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| |
Collapse
|
4
|
Lamb MM, Russel SM, Farzal Z, Kim S, Stack T, Alicea Delgado D, Mohammad I, Zeatoun A, Klatt-Cromwell CN, Thorp BD, Ebert CS, Kimple AJ, Senior BA, Lopez E. "Left on their own": Left-handedness among rhinologists and otolaryngology trainees. Int Forum Allergy Rhinol 2024; 14:735-737. [PMID: 37409408 PMCID: PMC11065428 DOI: 10.1002/alr.23231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/07/2023]
Abstract
KEY POINTS Left-hand-dominant (LHD) respondents reported higher rates of training difficulties because of handedness differences. LHD respondents cited particular difficulty with functional endoscopic sinus surgery. Both LHD and right-hand-dominant respondents perceived a need for laterality-specific training during residency.
Collapse
Affiliation(s)
- Meredith M Lamb
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sarah M Russel
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Zainab Farzal
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sulgi Kim
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Taylor Stack
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Daniel Alicea Delgado
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ibtisam Mohammad
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Abdullah Zeatoun
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Cristine N Klatt-Cromwell
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brian D Thorp
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Charles S Ebert
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Adam J Kimple
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brent A Senior
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Erin Lopez
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| |
Collapse
|
5
|
Moutos CP, Arena Goncharov DD, Saad AF, Richardson G, Jain S. Left-Handedness in Obstetrics and Gynecology: A Nationwide Survey of U.S. Trainees and Educators. Am J Perinatol 2023; 40:1820-1826. [PMID: 34808684 DOI: 10.1055/s-0041-1739406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aimed to evaluate the views and influence of left-handedness among obstetrics and gynecology (OBGYN) trainees and educators and to identify perceived obstacles in training by left-handed (LH) trainees. STUDY DESIGN An online survey was sent to the U.S. Obstetrics and Gynecology training programs. All participants were asked questions on hand preference for various medical and nonmedical activities, as well as on demographics. Participant responses to handedness and their role as a learner or educator directed them toward further questions. Trainees were surveyed on their experience and outlook as a LH physician in OBGYN. Educators were surveyed on their experience and attitudes in working with LH trainees. LH educators were also surveyed on their experience as a LH physician, similar to the LH trainees. Chi-square or Fisher's exact analysis was used as appropriate, with p-value <0.05 considered statistically significant. RESULTS Responses were received from 21 training programs, totaling 304 individuals. Participants included 205 learners (156 right handed and 49 left handed), and 99 faculty (82 right handed and 17 left handed). A lack of LH surgical instrument availability (93.6%) and difficulty using right-handed (RH) instruments (83%) were notable obstacles reported by LH learners. The majority of LH learners (57.4%) did not consider their handedness to be disadvantageous but did note added difficulty when training under RH mentors when compared with training under LH mentors (66%). In contrast to LH educators, RH educators endorsed added difficulty in instructing operative procedures to LH learners (32.1 vs. 13.3%, p = 0.012). CONCLUSION LH trainees face unique challenges during their OBGYN training. Educators would benefit from guidance on how best to manage these trainees. Educators should work to adapt surgical and procedural techniques to accommodate LH trainees. KEY POINTS · LH learners reported more difficulty in training under RH mentors.. · RH mentors reported increased difficulty in educating LH trainees.. · Neither trainees nor educators considered being LH a significant disadvantage..
Collapse
Affiliation(s)
- Christopher P Moutos
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Daphne D Arena Goncharov
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Antonio F Saad
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Gwyn Richardson
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Sangeeta Jain
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas
| |
Collapse
|
6
|
Brooks NE, Lipman JM, French JC. The Right Way to Teach Lefties - Exploring the Experiences of Left-Handed Trainees and Surgeons. JOURNAL OF SURGICAL EDUCATION 2023; 80:1552-1566. [PMID: 37563001 DOI: 10.1016/j.jsurg.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE This study describes the educational experiences of left-handed (LH) surgeons and provides recommendations for educating LH trainees, who face challenges due to their handedness. DESIGN, SETTING, AND PARTICIPANTS A mixed methods analysis was performed. Semi-structured interviews were conducted with LH trainees, LH attendings, and right-handed (RH) attendings representing 4 hospitals within a large academic hospital system. Questions were curated from current literature to explore the educational experiences of LH trainees. Inductive and iterative coding techniques were employed to manually generate themes. Laterality questionnaires for skills in daily life and surgery were collected and analyzed. RESULTS Laterality questionnaires demonstrate that LH trainees and surgeons are more mixed-handed and use their nondominant hand to a greater extent in surgery compared to daily life than RH attendings. Key themes were identified in the dimension of learning, including that initial decisions for which hand to use remain fixed throughout career, LH learning is largely self-directed, forced conformation to RH norms and microaggressions are common, LH instruments are rarely practical, and LH surgeons are advantaged with situational ambidexterity. Key themes related to teaching include that communication regarding handedness is lacking, RH surgeons are often unaware of/resistant to a LH approach, the onus is on the trainee to suggest accommodations to use their left hand, and attendings rarely effectively mentor LH learners in using their left hand. CONCLUSIONS Left-handed surgeons face challenges in an environment designed for RH individuals, represented by themes regarding learning and teaching experiences of LH surgeons told by themselves and their teachers. Recommendations were created for LH trainees in learning, all attendings in teaching, LH attendings in their opportunity to mentor, and surgical societies in supporting LH trainees. Development of resources for LH trainees could fill a substantial gap. Exploration of how LH surgeons evolve situational ambidexterity could benefit all surgeons.
Collapse
Affiliation(s)
- Nicole E Brooks
- Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio.
| | - Jeremy M Lipman
- Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - Judith C French
- Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| |
Collapse
|
7
|
Zagory JA, Ryan ML, Pandya SR. The Sinister Surgeon: Advanced Pediatric Minimally Invasive Surgery for Left-Handed Surgeons. J Laparoendosc Adv Surg Tech A 2023. [PMID: 37083498 DOI: 10.1089/lap.2022.0558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Purpose: Left-handed (LH) surgeons face unique challenges in their training and practice. Contrary to the historical and unjust perception of technical inferiority, LH surgeons can thrive under appropriate mentorship and support. Here, we describe modifications to pediatric minimally invasive surgeries to benefit the LH surgeon. Methods: The surgical approaches to common and complex pediatric surgical operations were modified to facilitate training of an LH pediatric surgical fellow. Results: Preoperative preparation, including communication with the operating room team, patient positioning, and provision of appropriate equipment, allowed the procedures to be accomplished in a safe and efficient manner. Conclusions: Modifying complex minimally invasive surgery to allow for use of the dominant hand is feasible and safe.
Collapse
Affiliation(s)
- Jessica A Zagory
- Division of Pediatric Surgery, Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Mark L Ryan
- Division of Pediatric Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Samir R Pandya
- Division of Pediatric Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| |
Collapse
|
8
|
Min SW, Kim H, Won D, Chang JE, Lee JM, Hwang JY, Kim TK. Comparison of the needle tip location with the operator's position during ultrasound-guided internal jugular vein catheterization: A randomized controlled study. Medicine (Baltimore) 2022; 101:e31249. [PMID: 36316874 PMCID: PMC9622659 DOI: 10.1097/md.0000000000031249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE We hypothesized that when a right-handed operator catheterizes the left internal jugular vein (IJV), the tip of the needle might be positioned closer to the center of the vessel after puncture if the operator is standing in the patient's left axillary line, rather than standing cephalad to the patient. METHODS The study randomly allocated 44 patients undergoing elective surgery under general anesthesia with planned left central venous catheterization to either conventional (operator stood cephalad to the patient) or intervention (operator stood in the patient's axillary line) groups. The left IJV was catheterized by 18 anesthesiologists. The distance between the center of the vessel and the needle tip, first-attempt success rate, and procedure time were compared. RESULTS The distance from the needle tip to the center of the IJV after needle puncture was 3.5 (1.9-5.5) and 3.2 (1.7-4.9) cm in the conventional and intervention groups, respectively (P = .47). The first-attempt success rate was significantly higher in the intervention group (100% vs 68.2%, P = .01). Overall time to successful guidewire insertion was faster in the intervention group (P = .007). CONCLUSIONS There was no significant difference in needle tip position when the right-handed operator was standing in the patient's left axillary line compared to standing cephalad to the patient during left IJV catheterization. However, it increased the first-attempt success rate and reduced the overall time for guidewire insertion.
Collapse
Affiliation(s)
- Seong-Won Min
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyerim Kim
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dongwook Won
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jee-Eun Chang
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung-Man Lee
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin-Young Hwang
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae Kyong Kim
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
- *Correspondence: Tae Kyong Kim, Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Republic of Korea (e-mail: )
| |
Collapse
|
9
|
Uppada UK, Sinha R, James K, Bhogaraju S, Pravallika B. Extent of Ambidexterity Among Oral and Maxillofacial Surgeons in Southern region of India: An Evaluative Study. J Maxillofac Oral Surg 2021. [DOI: 10.1007/s12663-021-01619-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
10
|
Affiliation(s)
- Prashant Patel
- Division of Cardiology, University of California Riverside School of Medicine, Riverside, California, USA.
| | - Mandira Patel
- Department of Medicine, University of California Riverside School of Medicine, Riverside, California, USA
| |
Collapse
|
11
|
Savetsky IL, Cammarata MJ, Kantar RS, Diaz-Siso JR, Avashia YJ, Rohrich RJ, Saadeh PB. The Left-handed Plastic Surgery Trainee: Perspectives and Recommendations. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2686. [PMID: 33133882 PMCID: PMC7572112 DOI: 10.1097/gox.0000000000002686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 01/15/2020] [Indexed: 12/04/2022]
Abstract
Left-handed surgeons experience difficulty with tools designed for use in the right hand. The purpose of this study was to examine instrument laterality and to survey the experiences of left-handed plastic surgery trainees.
Collapse
Affiliation(s)
- Ira L Savetsky
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, N.Y
| | - Michael J Cammarata
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, N.Y
| | - Rami S Kantar
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, N.Y
| | - J Rodrigo Diaz-Siso
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, N.Y
| | | | | | - Pierre B Saadeh
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, N.Y
| |
Collapse
|
12
|
Sabharwal S, MacKenzie JS, Sterling RS, Ficke JR, LaPorte DM. Left-Handedness Among Orthopaedic Surgeons and Trainees. JB JS Open Access 2020; 5:JBJSOA-D-20-00019. [PMID: 32832824 PMCID: PMC7418909 DOI: 10.2106/jbjs.oa.20.00019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: The impact of left-handedness on orthopaedic surgeons and trainees has not
been well described. We investigated the prevalence and perceived impact of
left-handedness among orthopaedic surgeons and trainees. Methods: We distributed a survey regarding handedness to active members of the
American Orthopaedic Association and the Council of Orthopaedic Residency
Directors affiliates, including department chairs, program directors, and
residency and fellowship program coordinators. Program coordinators were
asked to distribute the survey to their current residents and fellows. Results: Of 510 survey respondents, 78 (15%) were identified as left hand dominant
(LHD). Regarding scalpel/cautery use, 64% of LHD respondents reported using
their left hand primarily and 10% reported using their right hand primarily;
26% of LHD respondents described themselves as ambidextrous in
scalpel/cautery use, compared with 4.7% of right hand dominant (RHD)
respondents (p < 0.001). Regarding suturing, 53% of LHD respondents
reported using their left hand primarily and 38% reported using their right
hand primarily; 9.0% of LHD respondents described themselves as ambidextrous
when suturing, compared with 1.9% of RHD respondents (p = 0.012). Only
5.1% of LHD respondents reported having received laterality-specific
psychomotor training, whereas 17% perceived a need for such training during
residency; RHD respondents reported similar rates. Ambidexterity in
scalpel/cautery use or suturing among LHD respondents was not associated
with the perception that their left-handedness was advantageous. LHD
attending surgeons were more likely than LHD trainees to perceive their
handedness as advantageous (p = 0.007). Conclusions: Fifteen percent of orthopaedic surgeons and trainees who responded to our
survey were LHD. LHD respondents reported significantly higher rates of
ambidexterity in both scalpel/cautery use and suturing compared with RHD
respondents. Ambidexterity was not associated with a self-perception that
left-handedness was advantageous. LHD-attending surgeons were significantly
more likely than LHD residents/fellows to perceive their left-handedness as
advantageous. There may be benefits to pairing LHD residents with LHD
faculty surgeons early in their training to provide mentorship and insight
regarding performing surgical procedures left handed. Level of Evidence: Level IV.
Collapse
Affiliation(s)
- Samir Sabharwal
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - James S MacKenzie
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert S Sterling
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - James R Ficke
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dawn M LaPorte
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
13
|
Luvisa K, Fan KL, Black CK, Wirth P, Won Lee D, Del Corral G, Willey SC, Song DH. Does surgeon handedness or experience predict immediate complications after mastectomy? A critical examination of outcomes in a single health system. Breast J 2019; 26:376-383. [PMID: 31448506 DOI: 10.1111/tbj.13487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 05/13/2019] [Accepted: 05/17/2019] [Indexed: 11/28/2022]
Abstract
Surgeons often seek to perfect their technical dexterity, and hand dominance of the surgeon is an important factor given the constraints of operative field laterality. However, experience often dictates how surgeons are able to compensate. While surgeons have experienced preference for the ipsilateral breast, the impact of surgeon handedness, experience, and volume has not been directly examined in a single study. A retrospective chart review of five breast surgeons (2 LHD) at a single institution identified 365 mastectomy patients, totaling 594 breasts, between January 2015 and June 2018. The breasts were identified as ipsilateral or contralateral based on the surgeons' handedness. Surgeons were grouped based on length of surgical experience, three with ≥15 years and two with <15 years. Surgeons with greater experience were the highest volume surgeons in this series. Data included patient demographics, breast and oncologic history, surgical techniques, and surgical outcomes including complications. A total of 270 nonprophylactic and 324 prophylactic mastectomies were identified, of which 529 were performed by surgeons with greater than 15 years of experience and 65 by surgeons with less than 15 years. The overall complication rate was 33.5% (n = 199), of which 18.0% (n = 107) were on the ipsilateral breast and 15.5% (n = 92) were on the contralateral breast. 9.1% of complications required re-operation (n = 54). The odds of any complication on the ipsilateral breast were 2.9 times higher than complications on the contralateral breast when looking exclusively at surgeons with <15 years of experience (P = .0353, OR = 2.92, 1.06-8.03). Surgeons with <15 years of experience have a 2.71 (P = .05, OR 2.71, 1.361-5.373) increase in any ischemic complication and a 16 times (P < .0001, OR = 16.01, 5.038-50.933) increase in major operative ischemic complications. Our study finds that surgeons with less than 15 years of surgical experience have a 2.9 times higher rate of overall complication when operating on the ipsilateral breast. However, years of experience and surgeon volume have a much greater impact on any and ischemic complications after mastectomy.
Collapse
Affiliation(s)
- Kyle Luvisa
- Georgetown University School of Medicine, Washington, District of Columbia
| | - Kenneth L Fan
- MedStar Plastic and Reconstructive Surgery, Washington, District of Columbia
| | - Cara K Black
- Georgetown University School of Medicine, Washington, District of Columbia
| | - Peter Wirth
- Georgetown University School of Medicine, Washington, District of Columbia
| | - Dong Won Lee
- Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Gabriel Del Corral
- MedStar Plastic and Reconstructive Surgery, Washington, District of Columbia
| | - Shawna C Willey
- Department of General Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - David H Song
- MedStar Plastic and Reconstructive Surgery, Washington, District of Columbia
| |
Collapse
|
14
|
Deora H, Tripathi M, Yagnick NS, Deora S, Mohindra S, Batish A. Changing Hands: Why Being Ambidextrous Is a Trait That Needs to Be Acquired and Nurtured in Neurosurgery. World Neurosurg 2018; 122:487-490. [PMID: 30472285 DOI: 10.1016/j.wneu.2018.11.106] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/11/2018] [Accepted: 11/12/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this article is examine the issue of ambidexterity under the neurosurgical lens and demonstrate its need, its validity, and its advantages to neurosurgery as a whole. METHODS Inspiration can be derived from extraordinary circumstances that shaped ordinary people into legends. There have been instances in history where highly skilled professionals relying on hand motor skills had the misfortune of having to relearn their skill set with the other, less dominant hand. RESULTS We as neurosurgeons have always been ahead of the curve. It is only natural for us to understand the need and advantages of using both our hands with equal dexterity. Whether ambidexterity is an inherited trait or one that can be taught and, if practiced, mastered has been controversial. CONCLUSION These remarkable individuals from history demonstrate that if one is willing to practice without ego and one has the right motivation, one can use both hands with equal dexterity.
Collapse
Affiliation(s)
- Harsh Deora
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Education and Research, Lucknow, India
| | - Manjul Tripathi
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | | | - Sonali Deora
- Department of Radiodiagnosis, Narayana Hruduyala Hospital, Bangalore, India
| | - Sandeep Mohindra
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aman Batish
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|