Clinical Performance of Interns After Being on Call

Engel, Winslow; Seime, RJ; Powell,; R, D'Alessandri

doi:10.1097/00007611-198706000-00022

Cited by 39 publications

(6 citation statements)

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“…Others have reported that resident physicians sleep from zero to five hours while on call. 18,20,22,25,28,[40][41][42] Likewise, we did not include any measurement of supervision. The difference in errors we found could have been a function of fatigue, decreased supervision, or some other factor, rather than sleep deprivation.…”

Section: Limitationsmentioning

confidence: 99%

Overnight and Postcall Errors in Medication Orders

Hendey¹,

Barth

Soliz³

2005

Academic Emergency Medicine

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Section: Limitationsmentioning

confidence: 99%

Overnight and Postcall Errors in Medication Orders

Hendey¹,

Barth

Soliz³

2005

Academic Emergency Medicine

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“…Obstetrical residents (who slept for <2 hours) had no deterioration in their skills of placing an epidural during labor regardless of level of training. 50 Post-call residents (24 hours) demonstrated no impairment in their performance in structured clinical interviews with actors posing as patients, 51 laboratory form testing, 52 or simulated suturing technique. 52 A study by Storer et al 53 assessed the effect of 24 vs 36 hours of sleep deprivation on cognitive and procedural skills of pediatric residents; there was no deterioration in cognitive skills (written knowledge examination), endotracheal intubation, or vein catheterization associated with the longer shift.…”

Section: The Effect Of Traditional Extended Shifts On Residentsmentioning

confidence: 99%

Impact of extended duty hours on medical trainees

2016

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Many studies on resident physicians have demonstrated that extended work hours are associated with a negative impact on well-being, education, and patient care. However, the relationship between the work schedule and the degree of impairment remains unclear. In recent years, because of concerns for patient safety, national minimum standards for duty hours have been instituted (2003) and revised (2011). These changes were based on studies of the effects of sleep deprivation on human performance and specifically on the effect of extended shifts on resident performance. These requirements necessitated significant restructuring of resident schedules. Concerns were raised that these changes have impaired continuity of care, resident education and supervision, and patient safety. We review the studies on the effect of extended work hours on resident well-being, education, and patient care as well as those assessing the effect of work hour restrictions. Although many studies support the adverse effects of extended shifts, there are some conflicting results due to factors such as heterogeneity of protocols, schedules, subjects, and environments. Assessment of the effect of work hour restrictions has been even more difficult. Recent data demonstrating that work hour limitations have not been associated with improvement in patient outcomes or resident education and well-being have been interpreted as support for lifting restrictions in some specialties. However, these studies have significant limitations and should be interpreted with caution. Until future research clarifies duty hours that optimize patient outcomes, resident education, and well-being, it is recommended that current regulations be followed.

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“…These SDmediated effects have been demonstrated both for physical work [8] and for resting conditions [16] as well as for different professions, which are repeatedly exposed to sleep deprivation, sleep disruption and/or shift work such as airline pilots [ 12], firefighters [ 11 ], rotating shift workers [2] or hospital physicians [4,6,9].…”

Section: Introductionmentioning

confidence: 99%

“…In detail, these alterations of subjective well-being and psychosocial functioning include lower positive and higher negative mood scores, greater sleepiness ratings [11], fatigue and depression, changes in mood after 24 h or longer [4,9], reduced cognitive function [6], severe performance decrements 112] as well as psychological disturbances and family dysfunctions 12]. The above-mentioned impairments could be further corroborated by respective neuropsychological testing including vigilance tests, reaction time tasks and code tests [8].…”

Section: Introductionmentioning

confidence: 99%

The deterioration of mood and psychosocial functioning after sleep deprivation is preceded by an increase of serotoninergic transmission

et al. 2000

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Sleep deprivation (SD) in healthy humans is known to worsen individual mood and psychosocial performance. However, the timing of these impairments with respect to their physiological -in particular serotoninergic -underpinnings has remained unclear so far. We therefore investigated measures of subjective well-being and psychosocial functioning in 10 healthy male adults before and after SD as well as after recovery sleep. The serotoninergic response pattern to SD in this group was characterized by assessing platelet 5-HT2A receptor function and MAO-B activity. Taken together, SD induced a deterioration of both mood and ability to work, which was most prominent in the evening after SD, while the maximal increase of serotoninergic activity was observed twelve hours earlier, i.e., already in the morning following SD. Our findings support the hypothesis, that the deterioration of mood and psychosocial functioning after SD in healthy humans can be related to a preceding upregulation of the serotoninergic system as measured by the platelet 5-HT2A receptor function.Keywords healthy volunteers -platelet 5-HTaA receptor function -MAO-B activity.SchliisselwOrter gesunde Probanden -Blutpl~ittchen 5-HT2A-Rezeptorfunktion -MAO-B Aktivit~it. r-q

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Clinical Performance of Interns After Being on Call

Abstract: I recently reported on a series of indepth interviews with house officers in 16 specialties.

Cited by 39 publications

References 0 publications

Overnight and Postcall Errors in Medication Orders

Overnight and Postcall Errors in Medication Orders

Impact of extended duty hours on medical trainees

The deterioration of mood and psychosocial functioning after sleep deprivation is preceded by an increase of serotoninergic transmission

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