Previously submitted to: JMIR Human Factors (no longer under consideration since Nov 17, 2025)
Date Submitted: Nov 17, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A Human Factors Analysis of Personal Electronic Device Use and Cognitive Distractions in Orthopedic Surgery
ABSTRACT
Background:
The increasing ubiquity of personal electronic devices (PEDs) has introduced new cognitive challenges in high-stakes environments such as orthopedic surgery. While PEDs offer communication and informational utility, their misuse during clinical care has raised concerns about situational awareness, workflow disruption, and patient safety.
Objective:
This study applies human factors methodology to quantify and classify PED-related distractions during orthopedic surgical procedures.
Methods:
Structured observations were conducted during 40 orthopedic surgeries (hip and knee replacements), totaling 145 hours at a community hospital. PED-related events were documented in real time, and analyzed for their frequency, duration, and impact by team member role.
Results:
A total of 487 PED-related events were observed, totaling 18.76 hours (12.93% of surgical time). Vendors (30.4%), circulating nurses (23.6%), CRNAs (20.33%), technologists (7.80%), anesthesiologists (6.37%), radiology technicians (5.54%), first assists (3.70%), and surgeons (2.26%) frequently used the PEDs during orthopedic surgical phases.
Conclusions:
PED use in orthopedic settings poses measurable risks to operational performance and safety. Findings support the need for targeted human factors interventions, including role-specific usage guidelines, cognitive load mitigation strategies, and the redesign of intraoperative workflows to support attentional resilience and mitigate latent safety threats.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.