Clinical Review

Ergonomics in medicine and surgery

BMJ 2004; 328 doi: (Published 06 May 2004) Cite this as: BMJ 2004;328:1115
  1. Robert Stone, professor of interactive multimedia systems (,
  2. Rory McCloy, senior lecturer in surgery2
  1. 1Human Interface Technology Team, Department of Electronic, Electrical and Computer Engineering, University of Birmingham B15 2TT,
  2. 2Clinical Research Divisions I and II, Surgery, University of Manchester M13 9WL
  1. Correspondence to: R Stone
  • Accepted 17 March 2004


In just a few years, the roles of medical and surgical practitioners have undergone a major transformation, owing to developments in a new generation of advanced technologies such as surgical robotics, in-theatre interactive three dimensional displays, speech recognition for the control of critical theatre systems, virtual reality simulators, telemedicine, telecare, and e-learning. Yet despite the research and development community's enthusiasm for innovation, the end users—practitioners and specialists—are often ignored during the design and development processes, sometimes with serious consequences. We describe the growing relevance of ergonomics or human factors principles and methodologies to medical and surgical practice, emphasising the importance of moving away from “technology push” (the assumption that a high tech approach to the design of information technology systems will always provide a robust, reliable solution) to one that is more focused on the needs of the human in the design of medical equipment, systems, and processes.

Sources and selection criteria

The discipline of ergonomics has attempted to make important changes over half a century by introducing human centred processes to the design of equipment, systems, and working practices in many domains of activity, including health care. This review is based on our experience in introducing ergonomics into medical research and development programmes, together with data taken from sources bridging medical, industrial, and defence communities, including information obtained through key texts, the UK Ergonomics Information Analysis Centre, the US Human Systems Information Analysis Center, and international ergonomics and medical websites.


Ergonomics is the study (or science) of the interaction between humans and their working environment (box 1). Also known as human factors (a term originating from the United States, but gaining popularity in Europe), it has had a long and successful history of influencing the uptake of human centred design processes in different domains, such as the automotive industry and defence, and, to …

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