A0271 - Practice Makes Permanent: Implementing Ergonomic Training During Fellowship to Prevent Future Endoscopic Burn-Out

Allison P. Rzepczynski, MD¹, Vikram Kotwal, MD², Hetal Kulkarni, PT, MS, OCS, Cert. MDT³, Jacob Cingano, DPT⁴, Kenneth A. Barnett, PT, DPT³, Kelsey Kaiser, ATC³, Tiffani Strasburg, PTA⁵, Irving Waxman, MD, FACG^1
1Rush University Medical Center, Chicago, IL; ²Cook County Health, Chicago, IL; ³Rush Physical Therapy, Chicago, IL; ⁴Rush Physical Therapy, Flossmoor, IL; ⁵RUSH Physical Therapy, Lake in the Hills, IL

Introduction: Musculoskeletal injuries from performing endoscopy are common amongst gastroenterology fellows. The ASGE recently published the Ergonomics Core Curriculum, which states that training programs should incorporate formal ergonomics training into their curricula. However, the best method of doing this is unknown. In this study, we assessed whether one-on-one evaluation and feedback by physical therapists (PT) would improve ergonomics during endoscopy amongst GI fellows.

Methods: This study was a Quality Improvement project approved by the Institutional Review Board. A total of 8 fellows participated in the study. Demographic data and baseline information about musculoskeletal injuries and ergonomics training was obtained. The study was 2 phases. During phase 1, each fellow was observed by PT during one colonoscopy procedure and feedback regarding improving ergonomics and stretching exercises was provided afterwards. At the end of phase 1, a group session was organized to further educate fellows about common sites of musculoskeletal pain and stretches to avoid them. Phase 2 of the study was done 10 weeks later, and fellows were again observed for one colonoscopy procedure by PT and one-on-one feedback was provided. A post-intervention survey was conducted 3 weeks later.

Results: 7 fellows had previous training on ergonomics. Despite this, only 3 fellows properly adjusted the bed height and monitor position prior to the procedure during phase 1. Sustained awkward postures were observed in 7 fellows, most common being forward head/cervical extension, elbow flexion, wrist extension, forearm pronation and lumbar flexion. 3 fellows reported musculoskeletal pain secondary to performing endoscopy prior to phase 1. 2 fellows reported improvement in pain after phase 1; however, sustained awkward postures were persistent and only 1 additional fellow properly adjusted bed height and monitor position after phase 1. 2 additional fellows reported musculoskeletal pain after phase 1 and incorporated helpful changes in phase 2. While none of the fellows did any stretching prior to the study, 6 fellows reported doing some form of stretching on days they performed endoscopy after training by PT. The fellows reported that stretching instructions were the most helpful intervention.

Discussion: Sustained awkward postures during endoscopy persisted among GI fellows even after one-on-one feedback by PT. However, musculoskeletal pain from endoscopy appeared to improve, with stretching exercises being most helpful.



Disclosures:


Allison P. Rzepczynski, MD¹, Vikram Kotwal, MD², Hetal Kulkarni, PT, MS, OCS, Cert. MDT³, Jacob Cingano, DPT⁴, Kenneth A. Barnett, PT, DPT³, Kelsey Kaiser, ATC³, Tiffani Strasburg, PTA⁵, Irving Waxman, MD, FACG¹. A0271 - Practice Makes Permanent: Implementing Ergonomic Training During Fellowship to Prevent Future Endoscopic Burn-Out, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.