TY - JOUR
T1 - Association of workload of on-call medical interns with on-call sleep duration, shift duration, and participation in educational activities
AU - Arora, Vineet M.
AU - Georgitis, Emily
AU - Siddique, Juned
AU - Vekhter, Ben
AU - Woodruff, James N.
AU - Humphrey, Holly J.
AU - Meltzer, David O.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/9/10
Y1 - 2008/9/10
N2 - Context: Further restrictions in resident duty hours are being considered, and it is important to understand the association between workload, sleep loss, shift duration, and the educational time of on-call medical interns. Objective: To assess whether increased on-call intern workload, as measured by the number of new admissions on-call and the number of previously admitted patients remaining on the service, was associated with reductions in on-call sleep, increased total shift duration, and lower likelihood of participation in educational activities. Design, Setting, and Participants: Prospective cohort study of medical interns at a single US academic medical center from July 1, 2003, through June 24, 2005. Of the 81 interns, 56 participated (69%), for a total of 165 general medicine inpatient months resulting in 1100 call nights. Main Outcome Measures: On-call sleep duration, estimated by wrist watch actigraphy; total shift duration, measured from paging logs; and participation in educational activities (didactic lectures or bedside teaching), measured by experience sampling method via a personal digital assistant. Results: Mean (SD) sleep duration on-call was 2.8 (1.5) hours and mean (SD) shift duration was 29.9 (1.7) hours. Interns reported spending 11% of their time in educational activities. Early in the academic year ( July to October), each new on-call admission was associated with less sleep (-10.5 minutes [95% confidence interval {CI}, -16.8 to -4.2 minutes]; P<.001) and a longer shift duration (13.2 minutes [95% CI, 3.2-23.3 minutes]; P=.01). A higher number of previously admitted patients remaining on the service was associated with a lower odds of participation in educational activities (odds ratio, 0.82 [95% CI, 0.70-0.96]; P=.01]. Call nights during the week and early in the academic year were associated with the most sleep loss and longest shift durations. Conclusion: In this study population, increased on-call workload was associated with more sleep loss, longer shift duration, and a lower likelihood of participation in educational activities.
AB - Context: Further restrictions in resident duty hours are being considered, and it is important to understand the association between workload, sleep loss, shift duration, and the educational time of on-call medical interns. Objective: To assess whether increased on-call intern workload, as measured by the number of new admissions on-call and the number of previously admitted patients remaining on the service, was associated with reductions in on-call sleep, increased total shift duration, and lower likelihood of participation in educational activities. Design, Setting, and Participants: Prospective cohort study of medical interns at a single US academic medical center from July 1, 2003, through June 24, 2005. Of the 81 interns, 56 participated (69%), for a total of 165 general medicine inpatient months resulting in 1100 call nights. Main Outcome Measures: On-call sleep duration, estimated by wrist watch actigraphy; total shift duration, measured from paging logs; and participation in educational activities (didactic lectures or bedside teaching), measured by experience sampling method via a personal digital assistant. Results: Mean (SD) sleep duration on-call was 2.8 (1.5) hours and mean (SD) shift duration was 29.9 (1.7) hours. Interns reported spending 11% of their time in educational activities. Early in the academic year ( July to October), each new on-call admission was associated with less sleep (-10.5 minutes [95% confidence interval {CI}, -16.8 to -4.2 minutes]; P<.001) and a longer shift duration (13.2 minutes [95% CI, 3.2-23.3 minutes]; P=.01). A higher number of previously admitted patients remaining on the service was associated with a lower odds of participation in educational activities (odds ratio, 0.82 [95% CI, 0.70-0.96]; P=.01]. Call nights during the week and early in the academic year were associated with the most sleep loss and longest shift durations. Conclusion: In this study population, increased on-call workload was associated with more sleep loss, longer shift duration, and a lower likelihood of participation in educational activities.
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U2 - 10.1001/jama.300.10.1146
DO - 10.1001/jama.300.10.1146
M3 - Article
C2 - 18780843
AN - SCOPUS:51449095959
VL - 300
SP - 1146
EP - 1153
JO - JAMA - Journal of the American Medical Association
JF - JAMA - Journal of the American Medical Association
SN - 0098-7484
IS - 10
ER -