Addressing Gender Disparity in Surgery: Rethinking A One-Size-Fits-All Approach to Immersive Endoscopy.

OBJECTIVE: Using the lenses of Maslow's hierarchy of needs, this study examined the experience of female surgical trainees in endoscopy training. It investigated the influence of ergonomics on learning in this setting and in particular, looked to assess whether immersive training is a viable method by which female surgical trainees can learn colonoscopy. DESIGN, SETTING AND PARTICIPANTS: Training Programme Directors (TPDs) across the UK were approached to seek gatekeeper access to female higher general surgical trainees. A total of 10 trainees were recruited and semi-structured interviews were carried out over video conferencing software to gain insight into their views on the topic. Interviews were recorded, transcribed and analyzed using the Braun and Clarke method of thematic analysis. RESULTS: The majority of female surgical trainees find the endoscope difficult to handle, straining to reach all the component parts and experiencing issues maneuvering the scope. This led some to feel frustrated and even "mentally defeated" over time. Several trainees reported a lack of awareness of ergonomics as an issue for women in endoscopy, with many themselves identifying that they thought their issues were a "me problem," rather than being a wider issue with the scope. There were a number of positives regarding immersive training, including the volume of scopes achieved, building confidence and nurturing a training environment. The majority still felt, however, that condensed training in the immersive setting could be physically and mentally demanding. CONCLUSION: There is a lack of acknowledgement and awareness of ergonomic issues in endoscopy for female surgical trainees. Immersive training may be of benefit to tackle some of the issues with access to endoscopy, but incorporating ergonomics and spaced learning need to be considered when planning its provision.