Kelly-Schuette Kathrine, Shaker Tamer, Carroll Joseph, Davis Alan T, Wright G Paul, Chung Mathew
J Grad Med Educ. 2021 Feb;13(1):113-118. doi: 10.4300/JGME-D-20-00304.1. Epub 2020 Dec 31.
Surgical residency training has an extended tradition of long hours. Residency programs use a variety of call schedules to combat resident fatigue and sleep deprivation while maintaining adherence to duty hour restrictions. Nonetheless, there is a paucity of data regarding objective measurements of sleep during the different call schedules included in general surgery training.
The primary objective of this study was to compare the quantity of sleep in 24-hour time frames across all types of shifts worked by general surgery residents at our institution. The secondary objective was to measure activity level in total steps during various time frames.
This prospective observational study was performed between April 4 and August 26, 2018, with general surgery residents. Each resident was assigned a Fitbit Charge 2 to wear during all rotations, including general surgery and subspecialty services.
Twenty-six out of 31 residents voluntarily participated in the study (84%). In-house call (IHC) had significantly less sleep in a 24-hour time frame than home call and night float (144 vs 283 vs 246 minutes, < .001 and < .028). IHC had significantly more steps than home call (11 245 vs 8756 steps, = .039). The smallest number of steps was obtained when residents were not working (7904 steps).
Our data demonstrate that surgical residents on IHC have significantly less sleep compared to all other types of on-call time frames. Residents on IHC have the most steps across all time frames.
外科住院医师培训长期以来一直存在工作时间长的传统。住院医师培训项目采用各种值班时间表来应对住院医师的疲劳和睡眠剥夺,同时保持对工作时间限制的遵守。尽管如此,关于普通外科培训中不同值班时间表期间睡眠客观测量的数据却很少。
本研究的主要目的是比较我院普通外科住院医师在所有类型班次的24小时时间段内的睡眠量。次要目的是测量不同时间段内的总步数活动水平。
这项前瞻性观察性研究于2018年4月4日至8月26日对普通外科住院医师进行。每位住院医师在所有轮转期间,包括普通外科和专科服务,都被分配佩戴一个Fitbit Charge 2。
31名住院医师中有26名自愿参与了该研究(84%)。在24小时时间段内,院内值班(IHC)的睡眠时间明显少于在家值班和夜间轮值(144分钟对283分钟对246分钟,<.001和<.028)。院内值班的步数明显多于在家值班(11245步对8756步,=.039)。住院医师不工作时步数最少(7904步)。
我们的数据表明,与所有其他类型的值班时间段相比,进行院内值班的外科住院医师睡眠时间明显更少。在所有时间段内,进行院内值班的住院医师步数最多。