<h4>Background</h4>The Hawthorne effect or 'observer effect' describes a change in normal behaviour when individuals are aware they are being observed. This may have an impact on effect estimates in clinical trials. The purpose of this study was to determine if the Hawthorne effect had been recorded as a risk of bias in surgical studies.<h4>Methods</h4>A Preferred Reporting Items for Systematic Reviews and Meta-Analyses compliant literature search was conducted till March 2019. Eligible studies included those reporting or not reporting the Hawthorne effect in surgical studies from the following databases: MEDLINE, Embase, CINAHL, AMED, BNI, HMIC, PsycINFO, Web of Science, Cochrane Library, Google Scholar and OpenGrey. Two reviewers independently reviewed the papers, extracted data and appraised study methods using the Newcastle Ottawa Scale or the Cochrane risk of bias tool. Data were analysed descriptively.<h4>Results</h4>A total of 842 papers were identified, of which 16 were eligible. Six (37%) observational studies were identified with the aim of measuring the Hawthorne effect on their outcome with five reporting that the Hawthorne effect was responsible for the improvements in outcomes and one reporting no change in outcome due to the Hawthorne effect. Ten (63%) studies were identified, of which eight used the Hawthorne effect as an explanation to improvements seen in the control group or their secondary outcomes and two to compare their results with other studies.<h4>Conclusion</h4>There is considerable between-study heterogeneity on how the Hawthorne effect relates to surgical outcomes. Further consideration on reporting and considering the importance of the Hawthorne effect in the design of surgical trials is warranted.

The Hawthorne effect is a change in behavior resulting from awareness of being observed or evaluated. This study aimed to determine whether awareness of being evaluated or presence of an observer influence gait. Twenty-one young women were asked to walk in three conditions. In the first condition (unawareness of evaluation; UE), participants were aware that it was a practice trial, and there was no observer. In the second condition (awareness of evaluation; AE), participants were aware that their gait was being evaluated. The third condition (AE + researcher observation; RO) was similar to the second condition except that an additional researcher observed the participant' gait. The spatiotemporal, kinematic, ground reaction forces, and ratio index (symmetry of both lower limbs) were compared among the three conditions. A higher ratio index indicated a relative increase in the value on left versus right. Gait speed (P = 0.012) and stride length (right and left; P = 0.006 and 0.007, respectively) were significantly increased in the AE + RO than in UE. Range of motion of the right hip and left ankle was significantly greater in AE than in UE (P = 0.039 and 0.012, respectively). The ratio index of ground reaction force during push-off was significantly higher in AE and AE + RO conditions than in UE (P < 0.001 and P = 0.004, respectively). The Hawthorne effect (awareness of being evaluated or presence of an observer) potentially influences gait. Thus, factors that influence gait analysis should be considered when evaluating normal gait.

Introduction: Hawthorne effect refers to changes in clinician behavior in response to being observed. It has been minimally evaluated in trauma and surgical research, especially in low- and middle-income countries (LMICs). Methods: We used data from the first (control) phase of a randomized clinical trial in Ghana (2020-21). Trained observers were stationed in emergency units in eight non-tertiary hospitals to observe achievement of key performance indicators (KPIs) of trauma care. We hypothesized that the observers’ presence would create a Hawthorne effect, resulting in clinicians (doctors, nurses) performing above their usual level, with performance highest immediately after the observers were introduced, and with performance then declining over time towards usual baseline. Results: We enrolled 2,067 injured patients. Achievement of 13 out of 16 KPIs declined significantly over the 14 months after introduction of observers. For example, airway assessment declined from 77% initially to 60% at the end of the phase (p<0.001). Chest examination declined from 66% to 31% (p<0.001). Distal pulses checked declined from 45% to 7% (p<0.001). The slope of decline in KPI achievement ranged from 0.8%/month (mobility assessed) to 15.9%/month (distal pulses checked). Conclusions: The decline in KPI achievement over time is consistent with the hypothesis that clinicians performed above their usual level just after the observers were introduced, with performance then declining towards usual baseline. This study is among the first to provide quantitative data on the Hawthorne effect for trauma research in LMICs. These data are useful for the design of future observational studies and clinical trials.

Abstract Introduction The use of wearable technology in surgery has increased over time. This can be used to monitor pre-operative vital signs, footwear use in orthopaedics, and post-operative physical activity during recovery, among others. The Hawthorne effect may play an important role in wearable technology, such that awareness of being monitored leads to participants’ increased compliance with interventions. The aim of this systematic review was to ascertain the acknowledgement and implementation of the Hawthorne effect in studies pertaining to wearable technology. Methods Published and unpublished literature databases, conference proceedings and the reference lists of included studies were searched to the 31st of August 2024. Studies were eligible if they acknowledged the Hawthorne effect on wearable technology, evaluated its effect on patient outcomes, or utilised it to achieve behaviour change. Results A total of 16,314,027 records implementing wearable technology were identified. Of these, only 28 acknowledged the existence of the Hawthorne effect (0.0002%) (2,786 subjects): 1) Twenty-one studies (75%) recognised that the Hawthorne effect could impact results, of which thirteen clearly stated how outcomes were affected; 2) Four studies (14.3%) minimised the Hawthorne effect, of which two reported that controlling for this altered the results of the study; and 3) Three studies (10.7%) aimed to utilise the Hawthorne effect to achieve behaviour change. Conclusion The Hawthorne effect must be controlled for in surgical randomised controlled trials implementing such technologies, and considered when reporting on their use. This phenomenon can be harnessed to change patient behaviour and yield positive outcomes.

people's behavior can change when they think they are being observed. Although the Hawthorne research can be found in psychology textbooks, the research Psychology is the scientific study of the mind and behavior. Its subject matter includes the behavior of humans and nonhumans, both conscious and unconscious phenomena, and mental processes such as thoughts, feelings, and motives. Psychology is an academic discipline of broad scope, crossing the boundaries between the natural and social sciences. A professional practitioner or researcher involved Industrial and organizational (I/O) psychology involves research and practice that apply psychological theories and principles to the work lives of individuals and organizations. In the field's beginnings, industrialists brought the nascent field of psychology to bear on the study of scientific management techniques for improving workplace efficiency. The field was at first called economic psychology or business psychology; later, industrial psychology, employment psychology, or psychotechnology. An influential early study examined workers at Western Electric's Hawthorne plant in Cicero, Illinois from 1924 to 1932. Western Electric experimented on factory workers to assess their responses to changes in illumination, breaks, food, and wages. The researchers came to focus on workers' responses to observation itself, and the term Hawthorne effect is now used to describe the phenomenon in which people's behavior can change when they think they are being observed. Although the Hawthorne research can be found in psychology textbooks, the research and its findings were weak at best. The name industrial and organizational psychology emerged in the 1960s. In 1973, it became enshrined in the name of the Society for Industrial and Organizational Psychology, Division 14 of the American Psychological Association. One goal of the discipline is to optimize human potential in the workplace. Personnel psychology is a subfield of I/O psychology. Personnel psychologists apply the methods and principles of psychology to select and evaluate workers. Another subfield, organizational psychology, examines the effects of work environments and management styles on worker motivation, job satisfaction, and productivity. Most I/O psychologists work outside of academia, for private and public organizations, and as consultants. A psychology consultant working in business today might expect to provide executives with information and ideas about their industry, their target markets, and the organization of their company. Organizational behavior (OB) is an allied field that studies human behavior within organizations. One way to differentiate I/O psychology from OB is that I/O psychologists…

tivation." The "Hawthorne Effect." One of the more significant results of the Hawthorne Stud¬ … response, it is called a reward, and if it weakens a response, it is called a punishment … Relations movement Hawthorne experiments Hawthorne effect Technical career Managerial career LEARNING