title: Effect of sleep deprivation on the performance of simulated laparoscopic surgical skill.
abstract: BACKGROUND
  Resident work hours may impact patient care. We hypothesized that "call-associated" acute sleep deprivation has no effect on technical dexterity as measured on a minimally invasive surgery trainer, virtual reality (MIST VR) surgical simulator.
  
  
  METHODS
  Thirty-five surgical residents were prospectively evaluated pre-call (rested), on-call (rested), and post-call (acutely sleep deprived). Participants completed questionnaires regarding sleep hours and level of fatigue. Technical skill was assessed using the MIST VR. Speed, errors, and economy of motion were automatically recorded by the MIST VR computer simulator. Data were analyzed by paired Student t test and analysis of variance.
  
  
  RESULTS
  Estimated hours of sleep and subjective indicators of fatigue were different between rested and sleep-deprived residents. The number of errors and time to complete all tasks increased at the post-call assessment.
  
  
  CONCLUSIONS
  Resident work schedules lead to sleep deprivation and fatigue. Call-associated sleep deprivation and fatigue are associated with increased technical errors in the performance of simulated laparoscopic surgical skills.
authors.affiliation: Southwestern Center for Minimally Invasive Surgery and the Division of Burns, Trauma, and Surgical Critical Care, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390-9158, USA. brian.eastridge@utsouthwestern.edu
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Eastridge
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Hamilton
authors.forename: Grant E
authors.initials: GE
authors.lastname: O'Keefe
authors.forename: Robert V
authors.initials: RV
authors.lastname: Rege
authors.forename: Rawson J
authors.initials: RJ
authors.lastname: Valentine
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Jones
authors.forename: Seifu
authors.initials: S
authors.lastname: Tesfay
authors.forename: Erwin R
authors.initials: ER
authors.lastname: Thal
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D013502:General Surgery / Q000193:education; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy; D008297:Male; D010561:Personnel Staffing and Scheduling; D012892:Sleep Deprivation; D013647:Task Performance and Analysis