Differences in day and night shift clinical performance in anesthesiology.
OBJECTIVE
This study examined whether anesthesia residents (physicians in training) performed clinical duties in the operating room differently during the day versus at night.


BACKGROUND
Fatigue from sleep deprivation and working through the night is common for physicians, particularly during residency training.


METHODS
Using a repeated-measures design, we studied 13 pairs of day-night matched anesthesia cases. Dependent measures included task times, workload ratings, response to an alarm light latency task, and mood.


RESULTS
Residents spent significantly less time on manual tasks and more time on monitoring tasks during the maintenance phase at night than during the day. Residents reported more negative mood at night than during the day, both pre- and postoperation. However, time of day had no effect on the mood change between pre- and postoperation. Workload ratings and the response time to an alarm light latency task were not significantly different between night and day cases.


CONCLUSIONS
Because night shift residents had been awake and working for more than 16 hr, the observed differences in task performance and mood may be attributed to fatigue. The changes in task distribution during night shift work may represent compensatory strategies to maintain patient care quality while keeping perceived workload at a manageable level.


CONCLUSIONS
Fatigue effects during night shifts should be considered when designing work-rest schedules for clinicians. This matched-case control scheme can also be applied to study other phenomena associated with patient safety in the actual clinical environment.
School of Engineering, Tufts University, Medford, Massachusetts, USA.
Caroline G L
CG
Cao
Matthew B
MB
Weinger
Jason
J
Slagle
Chuan
C
Zhou
Jennie
J
Ou
Shakha
S
Gillin
Bryant
B
Sheh
William
W
Mazzei
D000328:Adult; D000776:Anesthesiology; D002983:Clinical Competence; D003625:Data Collection; D003627:Data Interpretation, Statistical; D005221:Fatigue / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009551:Night Care; D009873:Operating Rooms; D012892:Sleep Deprivation; D012984:Software; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D014940:Work Schedule Tolerance / Q000523:psychology