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Jaglarz D, Kowalczewski J, Dudek P, Pankowski R, Marczak D, Grzelecki D. The influence of the surgeon's handedness and standing position at the operating table on the radiological outcomes in primary total knee arthroplasty. Knee 2024; 50:147-153. [PMID: 39178723 DOI: 10.1016/j.knee.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 06/30/2024] [Accepted: 08/03/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND The purpose of this study was to compare radiological outcomes of total knee arthroplasty (TKA) in mechanical alignment implant positioning in the coronal and sagittal planes depending on surgeons' handedness and their position at the operating table. METHODS A total number of 200 consecutive patients with idiopathic osteoarthritis and varus knees who underwent TKA were retrospectively included in this research. Patients were operated on by 4 surgeons (50 for each surgeon) selected according to their handedness and position at the operative table. Surgeon I (right-handed, standing at the operating table always on the right side); Surgeon II(left-handed, standing at the operating table always on the left side); Surgeon III (right-handed, standing at the operating table on the side of the operated limb); Surgeon IV (left-handed, standing at the operating table on the side of the operated limb). RESULTS Comparing postoperative radiological results statistically significant differences were calculated in the case of deviation from HKA angle (left TKA -1.5°; Interquartile Range [IQR] = -2.6-[-1] vs right TKA -3°; IQR = -4.5-[-2]; p = 0.01) for surgeon II and MPTA for surgeon IV (left TKA 0°; IQR = -1-0.5 vs right TKA 1°; IQR = 0-2; p < 0.01). Higher deviation from the mechanical alignment angles and implant positioning was revealed for a less convenient operation site for the surgeon. CONCLUSION We recommend that all surgeons performing TKAs from the less comfortable side should take great care in establishing the MPTA and HKA angles to avoid surgical errors in implant positioning and limb alignment.
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Affiliation(s)
- Daniel Jaglarz
- Department of Orthopaedics and Trauma Surgery, Ceynowa Hospital in Wejherowo, Jagalskiego 10, 84-200 Wejherowo, Poland.
| | - Jacek Kowalczewski
- Department of Orthopedics and Rheumoorthopedics, Centre of Postgraduate Medical Education, Prof. Adam Gruca Orthopedic and Trauma Teaching Hospital, Konarskiego 13, 05-400 Otwock, Poland.
| | - Piotr Dudek
- Department of Orthopedics and Rheumoorthopedics, Centre of Postgraduate Medical Education, Prof. Adam Gruca Orthopedic and Trauma Teaching Hospital, Konarskiego 13, 05-400 Otwock, Poland.
| | - Rafał Pankowski
- Department of Orthopaedics, Traumatology and Spine Surgery, Medical University of Gdańsk, Copernicus P.L. Sp z o.o. Hospital Gdańsk, Nowe Ogrody 1-6, 80-803 Gdańsk, Poland.
| | - Dariusz Marczak
- Department of Orthopedics and Rheumoorthopedics, Centre of Postgraduate Medical Education, Prof. Adam Gruca Orthopedic and Trauma Teaching Hospital, Konarskiego 13, 05-400 Otwock, Poland.
| | - Dariusz Grzelecki
- Department of Orthopedics and Rheumoorthopedics, Centre of Postgraduate Medical Education, Prof. Adam Gruca Orthopedic and Trauma Teaching Hospital, Konarskiego 13, 05-400 Otwock, Poland.
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Gilbert TJ, Anderson MS, Byrnes ME, Kim GY, Solano QP, Wan JH, Sack BS. The Inequitable Experiences of Left-Handed Medical Students in Surgical Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:868-873. [PMID: 38166317 DOI: 10.1097/acm.0000000000005627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
PURPOSE Left-handed medical students contend with unique educational barriers within surgery, such as lack of educational resources, lack of left-handed-specific training, and widespread stigmatization of surgical left-handedness. This study aimed to highlight the surgical experiences of left-handed medical students so educators may be empowered to act with greater care and appreciation of these students' circumstances. METHOD In this qualitative study, the authors conducted semistructured interviews on surgical experiences during medical school between January 31, 2021, and June 20, 2021, on 31 current surgical residents and fellows from 15 U.S. institutions and 6 surgical specialties. Left-handed trainees were included regardless of their surgical hand dominance. RESULTS The authors identified 3 themes related to left-handed medical students' surgical experience: (1) disorienting advice from faculty or residents, (2) discouraging right-handed pressures and left-handed stigmatization, and (3) educational wishes of left-handed medical students. Trainees describe dialogues during medical school in which their handedness was directly addressed by residents and faculty with disorienting and nonbeneficial advice. Often trainees were explicitly told which hand to use, neglecting any preferences of the left-handed student. Participants also described possible changes in future surgical clerkships, including normalization of left-handedness, tangible mentorship, or granular and meaningful instruction. CONCLUSIONS Left-handed medical students encounter unique challenges during their surgical education. These students report being disoriented by the variability of advice provided by mentors, discouraged by how pressured they feel to operate right-handed, and burdened by the need to figure things out by themselves in the absence of adequate left-handed educational resources. Surgical education leadership should detail the unique problems left-handed learners face, impartially elicit the learner's current operative hand preference, take responsibility for their left-handed students, promote acceptance and accommodation strategies of left-handed surgical trainees, and endeavor to improve the breadth of left-handed surgical resources.
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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.
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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
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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..
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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
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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.
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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
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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.
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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
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Othman B, Chandra R, Nestel D. Age of the leftie: the lived experience of left-handed surgeons. ANZ J Surg 2022; 92:2082-2087. [PMID: 35665585 PMCID: PMC9544471 DOI: 10.1111/ans.17837] [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: 04/12/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
Abstract
Background Left‐handers make up 10%–12% of all surgeons. Surgical education and practice by nature has significant technical demands but there is a paucity of data on left‐handers and training in surgery. The surgical curriculum has no specific salutation or recognition of left‐handers and the contributions and challenges they represent. Methods The purpose of the study was to explore, describe and understand the lived experience of left‐handed surgeons in relation to surgical education and training in Australia. Semi‐structured interviews were used to gather in‐depth information relating to the participants' experiences, viewpoints, beliefs and motivations. Results The responses of the participants involved were categorized using the data analysis method described by Colaizzi. Seven themes were identified: left‐handed surgeons are universal adapters; left‐handed instruments are not necessary for left‐handed trainees; most left‐handed trainees have experienced discrimination or negativity due to their laterality; ambidexterity is considered an advantage; communicating one's laterality is important; a formal mentoring program is not necessary; and simulation can be a complementary tool for left‐ handed trainees. Being a left‐handed surgical trainee need not be a negative experience. Conclusion With appropriate support and teaching, left‐handed trainees can develop into excellent surgeons. The themes from this study can be used by trainees, trainers and Colleges of surgical training to build awareness and optimize the training of future left‐handed surgeons.
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Affiliation(s)
- Bushra Othman
- Colorectal Unit, Box Hill Hospital, Eastern Health, Melbourne, Victoria, Australia.,Department of Surgery, Barwon Health, Geelong, Victoria, Australia.,Department of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Raaj Chandra
- Colorectal Unit, Box Hill Hospital, Eastern Health, Melbourne, Victoria, Australia.,Department of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Debra Nestel
- Department of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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Laparoscopic Ambidexterity in Left-Handed Trainees. J Surg Res 2022; 275:203-207. [PMID: 35305486 DOI: 10.1016/j.jss.2022.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/15/2021] [Accepted: 02/08/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION There is a paucity of objective data about the advantages or disadvantages of handedness in surgery. Given the need for ambidexterity in laparoscopic surgery, our study aimed to identify the patterns in handedness and performance on basic laparoscopic tasks. METHODS A retrospective analysis of intern laparoscopic performance on bimanual tasks was assessed for delta time (differences in task time between the dominant and nondominant hand) between left-hand and right-hand dominant interns. RESULTS Data were analyzed for 16 residents. 25% were left-handed dominant (4/16) and 75% were right-handed dominant (12/16). Of the left-handed surgeons, 75% (3/4) operated primarily with their right hand. There was a significant difference between the time to task completion in Task 2 of left-handed and right-handed residents with median (IQR) time 94 s (90.25-97) and 127 s (104.25-128.5), respectively (P value = 0.02). No significant difference was seen between left-handed and right-handed residents on Task 1 (50 s versus 49 s) and Task 3 (51 s versus 59.5 s). In all three tasks, however, left-handed dominant residents had smaller variability (IQR 4.5-8 s versus 7-24.25 s) and significantly shorter delta times. CONCLUSIONS Although true ambidexterity is rare, the ability to be facile with both hands is crucial for laparoscopic surgery. Our data show that variability in performance between the dominant hand and nondominant hand was remarkably smaller for left-hand dominant residents. This remains true despite the majority learning to operate with their nondominant hand. These data demonstrate a possible advantage to being left-hand dominant and may lead to further insights into variations of skill acquisition and improved curriculum development.
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Lombana NF, Naeger PA, Padilla PL, Falola RA, Cole EL. Ambidexterity in left-handed and right-handed individuals and implications for surgical training. Proc AMIA Symp 2021; 35:176-179. [DOI: 10.1080/08998280.2021.2008585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Nicholas F. Lombana
- Division of Plastic and Reconstructive Surgery, Baylor Scott & White Medical Center – Temple, Temple, Texas
| | - Patrick A. Naeger
- Department of Orthopaedic Surgery, University of Texas Medical Branch, Galveston, Texas
| | - Pablo L. Padilla
- Division of Plastic and Reconstructive Surgery, University of Texas Medical Branch, Galveston, Texas
| | - Reuben A. Falola
- Division of Plastic and Reconstructive Surgery, Baylor Scott & White Medical Center – Temple, Temple, Texas
| | - Eric L. Cole
- Division of Plastic and Reconstructive Surgery, University of Texas Medical Branch, Galveston, Texas
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Chandratre S, Soman A. Enhancing Graduate Medical Education for Left-Handed Learners. J Grad Med Educ 2021; 13:15-17. [PMID: 33680293 PMCID: PMC7901612 DOI: 10.4300/jgme-d-20-00366.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Cathenis K, Fleerakkers J, Willaert W, Ballaux P, Goossens D, Hamerlijnck R. Left-handedness in cardiac surgery: who's right? Acta Chir Belg 2020; 120:212-216. [PMID: 31311431 DOI: 10.1080/00015458.2019.1642599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
There is a paucity of literature describing potential issues related to lateral hand dominance in general and cardiac surgery. Nonetheless, during surgical training left-handedness can produce difficulties in the operating room that are not always understood or accepted by supervising right-handed surgeons. These problems can be easily overcome by practice and anticipation. This report aims to address laterality related issues in cardiac surgery and provide insight into techniques that may aid the left handed surgeon in a right handed dominated surgical environment. An ergonomically different approach, more convenient for the left-handed trainee, may facilitate learning, enhance confidence and increase surgeon satisfaction both for the trainer and trainee.
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Affiliation(s)
- K. Cathenis
- Department of Cardiac Surgery, AZ Maria Middelares Hospital, Ghent, Belgium
| | - J. Fleerakkers
- Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands
| | - W. Willaert
- Department of Vascular Surgery, AZ Maria Middelares Hospital, Ghent, Belgium
| | - P. Ballaux
- Department of Cardiac Surgery, AZ Maria Middelares Hospital, Ghent, Belgium
| | - D. Goossens
- Department of Cardiac Surgery, AZ Maria Middelares Hospital, Ghent, Belgium
| | - R. Hamerlijnck
- Department of Cardiac Surgery, AZ Maria Middelares Hospital, Ghent, Belgium
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Is Being Left Handed an Advantage toward a Plastic Surgery Residency? PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2589. [PMID: 32095399 PMCID: PMC7015585 DOI: 10.1097/gox.0000000000002589] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/28/2019] [Indexed: 11/26/2022]
Abstract
Background: Left hand dominance is a minority trait historically regarded as disadvantageous for surgeons. Contemporary scientific literature and folklore have shed new light on left handedness as a “boutique trait” and possible marker of gifted and exceptional individuals. Our subjective impression that left handedness is prevalent in the unique field of plastic surgery raised questions regarding the scope and possible causality of this phenomenon. Methods: One hundred eleven medical doctors in our medical center filled out a 13-item questionnaire regarding hand dominance, medical speciality, and various creative outlets or hobbies. Results: Sixty-four percent of the participating plastic surgeons were left handed (significantly higher than the approximate 12% of the general population; P = 0.007). Many of the left-handed doctors admitted to practicing musical instruments and various arts, crafts, and other hobbies. Conclusions: Plastic surgery is a unique profession requiring astute minds capable of creative and “outside-the-box” thinking; traits we have learned in recent decades may be particularly keen in left-handed individuals, perhaps suggest a causal relationship to the conglomeration of a majority of left-handed plastic surgeons.
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Prasad NK, Kvasnovsky C, Wise ES, Kavic SM. The Right Way to Teach Left-Handed Residents: Strategies for Training by Right Handers. JOURNAL OF SURGICAL EDUCATION 2018; 75:271-277. [PMID: 28756969 DOI: 10.1016/j.jsurg.2017.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/17/2017] [Accepted: 07/01/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Left-handed (LH) residents remain underrepresented among surgical trainees, and there are few available data on how best to train them. The challenge is amplified when pairing a LH resident with a right-handed (RH) mentor. This report provides recommendations on how to improve the training of LH surgeons in a safe and effective manner. METHODS A comprehensive literature review was performed using different databases and search engines to identify all articles relevant to the training of LH residents. RESULTS A total of 40 articles highlighted the challenges for LH surgical residents and RH mentors. Our recommendations are based on the following 4 themes: identifying inherent differences in left vs. RH residents, providing guidance to RH mentors training LH residents, adapting the RH environment to the LH surgeon, and maximizing safety during training. CONCLUSION An organized approach needs to be taken in training the LH resident. Changes should be instituted at program-wide and national levels to ensure that the training experience of the sinistral surgical resident is optimized.
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Affiliation(s)
- Nikhil K Prasad
- Department of Surgery, University Of Maryland Medical Center, Baltimore, Maryland
| | - Charlotte Kvasnovsky
- Department of Surgery, University Of Maryland Medical Center, Baltimore, Maryland
| | - Eric S Wise
- Department of Surgery, University Of Maryland Medical Center, Baltimore, Maryland
| | - Stephen M Kavic
- Department of Surgery, University Of Maryland Medical Center, Baltimore, Maryland.
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Anderson M, Carballo E, Hughes D, Behrer C, Reddy RM. Challenges training left-handed surgeons. Am J Surg 2017; 214:554-557. [DOI: 10.1016/j.amjsurg.2016.12.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/21/2016] [Accepted: 12/21/2016] [Indexed: 11/26/2022]
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Callahan D, de Virgilio C, Tillou A, DeUgarte DA. Medical student hand preference, perceived dexterity, and impact of handedness on training. J Surg Res 2016; 204:114-7. [DOI: 10.1016/j.jss.2016.04.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 03/28/2016] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
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Alnassar S, Alrashoudi AN, Alaqeel M, Alotaibi H, Alkahel A, Hajjar W, Al-shaikh G, Alsaif A, Haque S, Meo SA. Clinical psychomotor skills among left and right handed medical students: are the left-handed medical students left out? BMC MEDICAL EDUCATION 2016; 16:97. [PMID: 27004684 PMCID: PMC4804539 DOI: 10.1186/s12909-016-0611-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 03/08/2016] [Indexed: 05/05/2023]
Abstract
BACKGROUND There is a growing perception that the left handed (LH) medical students are facing difficulties while performing the clinical tasks that involve psychomotor skill, although the evidence is very limited and diverse. The present study aimed to evaluate the clinical psychomotor skills among Right-handed (RH) and left-handed (LH) medical students. METHODS For this study, 54 (27 left handed and 27 right handed) first year medical students were selected. They were trained for different clinical psychomotor skills including suturing, laparoscopy, intravenous cannulation and urinary catheterization under the supervision of certified instructors. All students were evaluated for psychomotor skills by different instructors. The comparative performance of the students was measured by using a global rating scale, each selected criteria was allotted 5-points score with the total score of 25. RESULTS There were no significant differences in the performance of psychomotor skills among LH and RH medical students. The global rating score obtained by medical students in suturing techniques was: LH 15.89 ± 2.88, RH 16.15 ± 2.75 (p = 0.737), cannulation techniques LH 20.44 ± 2.81, RH 20.70 ± 2.56 (p = 0.725), urinary catheterization LH 4.33 ± 0.96 RH 4.11 ± 1.05 (p = 0.421). For laparoscopic skills total peg transfer time was shorter among LH medical students compared to RH medical students (LH 129.85 ± 80.87 s vs RH 135.52 ± 104.81 s) (p = 0.825). However, both RH and LH students completed their procedure within the stipulated time. CONCLUSIONS Among LH and RH medical students no significant difference was observed in performing the common surgical psychomotor skills. Surgical skills for LH or RH might not be a result of innate dexterity but rather the academic environment in which they are trained and assessed. Early laterality-related mentoring in medical schools as well as during the clinical residency might reduce the inconveniences faced by the left-handed medical personnel.
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Affiliation(s)
- Sami Alnassar
- />Department of Thoracic Surgery and Department of Medical Education, Riyadh, Saudi Arabia
- />Thoracic Surgery, Department of Surgery (37) and Department of Medical Education, College of Medicine, King Saud University, PO Box 7805, Riyadh, 11472 Saudi Arabia
| | | | - Mody Alaqeel
- />Department of Medical Education, Riyadh, Saudi Arabia
| | - Hala Alotaibi
- />Department of Medical Education, Riyadh, Saudi Arabia
| | | | - Waseem Hajjar
- />Department of Thoracic Surgery and Department of Medical Education, Riyadh, Saudi Arabia
| | | | | | - Shafiul Haque
- />Department of Medical Education, Riyadh, Saudi Arabia
| | - Sultan Ayoub Meo
- />Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Pennington N, Redmond A, Stewart T, Stone M. The impact of surgeon handedness in total hip replacement. Ann R Coll Surg Engl 2014; 96:437-41. [PMID: 25198975 DOI: 10.1308/003588414x13946184902488] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Total hip replacement (THR) is successful and performed commonly. Component placement is a determinant of outcome. Influence of surgeon handedness on component placement has not been considered previously. This study was a radiographic assessment of component positioning with respect to handedness. Early data from 160 patients are reported. METHODS Overall, 160 primary THRs for osteoarthritis were included. Equal numbers of left and right THRs were performed by four surgeons, two right-handed and two left-handed. Postoperative radiography was assessed for THR component position by measurement of leg length inequality, acetabular inclination and centre of rotation. Surgeons' handedness was assessed using the Edinburgh inventory. RESULTS For leg length inequality, no significant interaction was seen between hip side and surgeon handedness. Acetabular inclination angles showed a statistically significant difference, however, depending on hand dominance, with higher inclination angles recorded when operating on the dominant side. There was a trend towards greater medialisation of the centre of rotation on the non-dominant side although this did not reach statistical significance. CONCLUSIONS Surgeon handedness appears to influence acetabular component position during THR but it is one factor of many that interact to achieve a successful outcome.
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Affiliation(s)
- N Pennington
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, UK
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Effects of laparoscopic instrument and finger on force perception: a first step towards laparoscopic force-skills training. Surg Endosc 2014; 29:1927-43. [DOI: 10.1007/s00464-014-3887-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 09/06/2014] [Indexed: 11/25/2022]
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Affiliation(s)
- Sulieman S. Al-Johany
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University
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21
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Tchantchaleishvili V, Myers PO. Left-handedness--a handicap for training in surgery? JOURNAL OF SURGICAL EDUCATION 2010; 67:233-6. [PMID: 20816359 DOI: 10.1016/j.jsurg.2010.06.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Revised: 05/06/2010] [Accepted: 06/03/2010] [Indexed: 05/21/2023]
Abstract
BACKGROUND Left-handedness was historically considered a disability and a social stigma, and teachers would make efforts to suppress it in their students. Little data are available on the impact of left-handedness on surgical training. This report reviews available data on this subject. METHODS We did systematic electronic and manual literature searches using a predetermined strategy independently by 2 investigators, 1 left- and 1 right-handed, to identify reports on surgical training and left-handedness. RESULTS The review revealed 19 studies on the subject of left-handedness and surgical training. Data were heterogeneous and based mostly on surveys. Left-handedness produced anxiety in residents and their trainers. There was a lack of mentoring on laterality. Surgical instruments, both conventional and laparoscopic, are not adapted to left-handed use and require ambilaterality training from the resident. There is significant pressure to change hand laterality during training. However, left-handedness might present an advantage in operations involving situs inversus or left lower limb operations. CONCLUSIONS Left-handedness is a challenge both for the trainee and the trainer in surgery. Early laterality-related mentoring in medical school and during surgical residency with provision of left-handed instruments might reduce the inconveniences of left-handed surgeons learning.
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Affiliation(s)
- Vakhtang Tchantchaleishvili
- Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
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Girard LP, Feasby TE, Eliasziw M, Quan H, Kennedy J, Barnett HJ, Ghali WA. Complication Rates After Left- Versus Right-Sided Carotid Endarterectomy. Circ Cardiovasc Qual Outcomes 2009; 2:642-7. [DOI: 10.1161/circoutcomes.109.850842] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Louis-Philippe Girard
- From the Department of Medicine (L.-P.G., T.E.F., W.A.G.), the Department of Community Health Sciences (M.E., H.Q., W.A.G.), and the Centre for Health and Policy Studies (H.Q., W.A.G.), University of Calgary, Alberta, Canada; the Nuffield Department of Clinical Medicine (J.K.), University of Oxford, UK; and the Robarts Research Institute (H.J.M.B.), London, Ontario, Canada
| | - Thomas E. Feasby
- From the Department of Medicine (L.-P.G., T.E.F., W.A.G.), the Department of Community Health Sciences (M.E., H.Q., W.A.G.), and the Centre for Health and Policy Studies (H.Q., W.A.G.), University of Calgary, Alberta, Canada; the Nuffield Department of Clinical Medicine (J.K.), University of Oxford, UK; and the Robarts Research Institute (H.J.M.B.), London, Ontario, Canada
| | - Michael Eliasziw
- From the Department of Medicine (L.-P.G., T.E.F., W.A.G.), the Department of Community Health Sciences (M.E., H.Q., W.A.G.), and the Centre for Health and Policy Studies (H.Q., W.A.G.), University of Calgary, Alberta, Canada; the Nuffield Department of Clinical Medicine (J.K.), University of Oxford, UK; and the Robarts Research Institute (H.J.M.B.), London, Ontario, Canada
| | - Hude Quan
- From the Department of Medicine (L.-P.G., T.E.F., W.A.G.), the Department of Community Health Sciences (M.E., H.Q., W.A.G.), and the Centre for Health and Policy Studies (H.Q., W.A.G.), University of Calgary, Alberta, Canada; the Nuffield Department of Clinical Medicine (J.K.), University of Oxford, UK; and the Robarts Research Institute (H.J.M.B.), London, Ontario, Canada
| | - James Kennedy
- From the Department of Medicine (L.-P.G., T.E.F., W.A.G.), the Department of Community Health Sciences (M.E., H.Q., W.A.G.), and the Centre for Health and Policy Studies (H.Q., W.A.G.), University of Calgary, Alberta, Canada; the Nuffield Department of Clinical Medicine (J.K.), University of Oxford, UK; and the Robarts Research Institute (H.J.M.B.), London, Ontario, Canada
| | - Henry J.M. Barnett
- From the Department of Medicine (L.-P.G., T.E.F., W.A.G.), the Department of Community Health Sciences (M.E., H.Q., W.A.G.), and the Centre for Health and Policy Studies (H.Q., W.A.G.), University of Calgary, Alberta, Canada; the Nuffield Department of Clinical Medicine (J.K.), University of Oxford, UK; and the Robarts Research Institute (H.J.M.B.), London, Ontario, Canada
| | - William A. Ghali
- From the Department of Medicine (L.-P.G., T.E.F., W.A.G.), the Department of Community Health Sciences (M.E., H.Q., W.A.G.), and the Centre for Health and Policy Studies (H.Q., W.A.G.), University of Calgary, Alberta, Canada; the Nuffield Department of Clinical Medicine (J.K.), University of Oxford, UK; and the Robarts Research Institute (H.J.M.B.), London, Ontario, Canada
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