BACKGROUND: Concerns about duty hour and resident safety have fostered discussion about postshift fatigue and driving impairment. OBJECTIVE: We assessed how converting to a night float schedule for overnight coverage affected driving safety for trainees. METHODS: Brake reaction times were measured for internal medicine and orthopaedic surgery resident volunteers after a traditional 28-hour call shift and after a night float shift. We conducted matched paired t tests of preshift and postshift reaction time means. Participants also completed the Epworth Sleepiness Scale pre- and postshift. RESULTS: From June to July 2013, we enrolled 58 interns and residents (28 orthopaedic surgery, 30 internal medicine). We included 24 (41%) trainees on night float rotations and 34 (59%) trainees on traditional 28-hour call shifts. For all residents on night float rotations, there was no significant difference pre- and postshift. An increase in reaction times was noted among trainees on 28-hour call rotations. This included no effect on reaction times for internal medicine trainees pre- and postshift, and an increase in reaction times for orthopaedic trainees. For both night float and traditional call groups, there were significant increases in the Epworth Sleepiness Scale. CONCLUSIONS: Trainees on traditional 28-hour call rotations had significantly worse postshift brake reaction times, whereas trainees on night float rotations had no difference. Orthopaedic trainees had significant differences in brake reaction times after a traditional call shift.
BACKGROUND: Concerns about duty hour and resident safety have fostered discussion about postshift fatigue and driving impairment. OBJECTIVE: We assessed how converting to a night float schedule for overnight coverage affected driving safety for trainees. METHODS: Brake reaction times were measured for internal medicine and orthopaedic surgery resident volunteers after a traditional 28-hour call shift and after a night float shift. We conducted matched paired t tests of preshift and postshift reaction time means. Participants also completed the Epworth Sleepiness Scale pre- and postshift. RESULTS: From June to July 2013, we enrolled 58 interns and residents (28 orthopaedic surgery, 30 internal medicine). We included 24 (41%) trainees on night float rotations and 34 (59%) trainees on traditional 28-hour call shifts. For all residents on night float rotations, there was no significant difference pre- and postshift. An increase in reaction times was noted among trainees on 28-hour call rotations. This included no effect on reaction times for internal medicine trainees pre- and postshift, and an increase in reaction times for orthopaedic trainees. For both night float and traditional call groups, there were significant increases in the Epworth Sleepiness Scale. CONCLUSIONS: Trainees on traditional 28-hour call rotations had significantly worse postshift brake reaction times, whereas trainees on night float rotations had no difference. Orthopaedic trainees had significant differences in brake reaction times after a traditional call shift.
Authors: Laura K Barger; Brian E Cade; Najib T Ayas; John W Cronin; Bernard Rosner; Frank E Speizer; Charles A Czeisler Journal: N Engl J Med Date: 2005-01-13 Impact factor: 91.245
Authors: Daniel J Buysse; Barbara Barzansky; David Dinges; Eileen Hogan; Carl E Hunt; Judith Owens; Mark Rosekind; Raymond Rosen; Frank Simon; Sigrid Veasey; Francine Wiest Journal: Sleep Date: 2003-03-15 Impact factor: 5.849
Authors: Ryan M Antiel; Darcy A Reed; Kyle J Van Arendonk; Sean C Wightman; Daniel E Hall; John R Porterfield; Karen D Horvath; Kyla P Terhune; John L Tarpley; David R Farley Journal: JAMA Surg Date: 2013-05 Impact factor: 14.766