A Mixed Methods Study for Human Factors Science and Ergonomics Education in Vascular Surgery Training

OBJECTIVE: Human factors science and ergonomics (HFE) is a scientific discipline that can mitigate risk, improve wellbeing, and optimise performance. Vascular surgery is a high acuity specialty: integration of HFE could improve traditional outcome measures such as length of procedure, length of stay, morbidity, and mortality, as well as the physical and psychological health of surgeons. However, access to relevant training is scarce. This study aimed to establish UK vascular surgery trainees' current knowledge and understanding of HFE and to define preferred content and characteristics for a future education programme. METHODS: This mixed methods study comprised quantitative survey and qualitative focus group data. A needs assessment comprising a survey of trainees in their first year of vascular surgery was performed. Descriptive statistics and thematic analyses were reported. A needs analysis comprising focus groups with surgical trainees in their third year was conducted. An inductive thematic analysis of anonymised transcripts identified codes and themes in relation to trainees' contextualised understanding of HFE, and experienced barriers and motivators to attending training. RESULTS: Surveyed trainees agreed or strongly agreed that HFE is relevant to vascular surgery (22 of 24; 92%), is important for patient safety (22 of 24; 92%), and is as important as technical ability (20 of 24; 83%). Focus groups described a pernicious surgical culture; a perceived inability to leave clinical work was a key barrier to attending non-mandatory training. Trainees were motivated to optimise individual and team operative performance and recognised the importance of communication to succeed in this. Desirable components of a future HFE education programme were simulation, clinical application, and a limited demand on time and money. CONCLUSION: There is an unmet need for specific, targeted, and accessible HFE education in vascular surgery. A clinically relevant programme should be designed to enhance performance and safety, improve surgical culture, and complement specialty specific technical training opportunities.