Please see the first article of the Spring 2026 issue!
Study Objectives: The increased use of computers at work has resulted in a similar increase in the number of musculoskeletal disorders reported. These disorders involve recurrent and persistent pain, may involve disability in any body part, and may happen progressively over periods of weeks to years. The goal of this pilot study was to assess the prevalence of ergonomic risk factors in emergency department (ED) clinicians while sitting at computer workstations.
Methods: This was a prospective, blinded, clinical assessment analysis conducted over a 2-month study period. ED clinicians (physicians, residents, and advanced practice providers) from a children’s tertiary care facility and a university-affiliated adult hospital were observed during routine computer tasks. Clinicians were blinded to the purpose of the study. Trained observers completed a Rapid Office Strain Assessment (ROSA) checklist to evaluate computer use ergonomic risk factors. ROSA final scores ranged in magnitude from 1 to 10, with higher scores representing increasing risk factors. A ROSA score of 5 is considered an action level indicating when immediate change is necessary. One-way analysis of variance tests was used to compare ergonomic assessments at each level of postgraduate training.
Results: Seventy-six ED providers were observed performing a total of 89 tasks on computers. Providers were residents (42.1%), faculty (30.3%), and advanced practice providers (27.6%). Computer tasks included dictation, placing orders, and reviewing digital records. The mean ROSA score for all providers was 3.4 (SD 1.0). Overall, 24.2% of clinicians were scored at high risk for musculoskeletal disorders (ROSA score was >4). ROSA scores did not differ significantly among the various levels of postgraduate training. Computer use risk factors included awkward postures of the wrist and forearm, improper sitting posture, height of chair and workstation, and lack of lumbar support.
Conclusions: The Rapid Office Strain Assessment (ROSA) can be used to quickly quantify ergonomic risks associated with each component of a typical computer workstation and provide information to the ED provider regarding the need for change. In this small study, almost one-quarter of providers demonstrated ergonomic risk factors that make them susceptible to musculoskeletal disorders. These results occurred irrespective of postgraduate training levels.