Abstract
Background
There have been conflicting reports of the effects of modest sleep deprivation on
surgical skills. The aim of this study was to assess the effects of a 24-hour call
shift on technical and cognitive function, as well as the ability to learning a new
skill.
Methods
Thirty-one students trained to expert proficiency on a virtual reality part-task trainer.
They then were randomized to either a control or sleep-deprived group. On the second
testing day they were given a novel task. Fatigue was assessed using the Epworth Sleepiness
Scale. The National Aeronautics and Space Administration–Task Load Index was used
to assess cognitive capabilities.
Results
There was no difference between the control and sleep-deprived groups for performance
or learning of surgical tasks. Subjectively, the Epworth Sleepiness Scale showed an
increase in sleepiness. The National Aeronautics and Space Administration–Task Load
Index showed an increase in total subjective mental workload for the sleep-deprived
group.
Conclusions
Sleep-deprived subjects were able to complete the tasks despite the increased workload,
and were able to learn a new task proficiently, despite an increase in sleepiness.
Keywords
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References
- Simulation in surgery: perfecting the practice.Surg Clin North Am. 2010; 90: 457-473
- Virtual reality training improves operating room performance: results of a randomized, double-blinded study.Ann Surg. 2002; 236: 458-464
- The impact of sleep deprivation on product quality and procedure effectiveness in a laparoscopic physical simulator: a randomized controlled trial.Am J Surg. 2005; 189: 753-757
- Effects of a twenty-four hour call period on resident performance during simulated endoscopic sinus surgery in an accreditation council for graduate medical education-compliant training program.Laryngoscope. 2005; 115: 143-146
- Impact of sleep deprivation on medium-term psychomotor and cognitive performance of surgeons: prospective crossover study with a virtual surgery simulator and psychometric tests.J Surg. 2010; 147: 246-254
- Electrooculographic and performances indices of fatigue during simulated flight.Biol Psychol. 1996; 42: 343-360
- Comparing the effects of fatigue and alcohol consumption on locomotive engineers' performance in a rail simulator.J Hum Ergol. 2001; 30: 125-130
- Neurobehavioral performance of residents after heavy night call vs after alcohol ingestion.JAMA. 2005; 294: 1025-1033
- The effect of sleep disruption on performance of anaesthetists—a pilot study.Anaesthesia. 2003; 58: 520-525
- Effect of fatigue on psychomotor and cognitive skills.Am J Surg. 2008; 195: 195-204
- Effect of sleep deprivation on surgeons' dexterity on laparoscopy simulator.Lancet. 1998; 352: 1191
- Laparoscopic skills suffer on the first shift of sequential night shifts: program directors beware and residents prepare.Ann Surg. 2008; 247: 530-539
- Development of NASA-TLX (task load index): results of empirical and theoretical research.in: Hancock P.A. Meshkati N. Human Mental Workload. North Holland Press, Amsterdam1988
- Measuring mental workload during the performance of advanced laparoscopic tasks.Surg Endosc. 2010; 24: 45-50
- Higher mental workload is associated with poorer laparoscopic performance as measured by the NASA-TLX tool.Sim Healthcare. 2010; 5: 267-271
- Single incision laparoscopic surgery (SILS) is associated with poorer performance and increased surgeon workload compared with standard laparoscopy.Am Surg. 2011; 77: 73-77
- Is the “sterile cockpit” concept applicable to cardiovascular surgery critical intervals or critical events?.J Thorac Cardiovasc Surg. 2010; 139: 312-319
- Time estimation during prolonged sleep deprivation and its relation to activation measures.Hum Factors. 2003; 45: 148-159
- The effects of sleep loss in a combined tracking and time estimation task.Ergonomics. 1994; 37: 1021-1030
- The effects of sleep deprivation on information-integration categorization performance.Sleep. 2009; 32: 1439-1448
- Sleep deprivation, elective surgical procedures, and informed consent.N Engl J Med. 2010; 363: 2577-2579
- The new recommendations on duty hours from the ACGME task force.N Engl J Med. 2010; 363: e3
- A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale.Sleep. 1991; 14: 540-545
- Smart tutor: a pilot study of a novel adaptive simulation environment.Stud Health Technol Inform. 2005; 111: 385-389
- Virtual-reality training improves angled telescope skills in novice laparoscopists.Am J Surg. 2007; 193: 260-265
- Reliability and validity of Endotower, a virtual reality trainer for angled endoscope navigation.Stud Health Technol Inform. 2002; 85: 179-184
- NASA-Task Load Index (NASA-TLX); 20 Years Later.in: Proceedings of the Human Factors and Ergonomics Society 50th Annual Meeting HFES, Santa Monica2006: 904-908
- Random-effects models for longitudinal data.Biometrics. 1982; 38: 963-974
- A review of studies concerning effects of sleep deprivation and fatigue on residents' performance.Acad Med. 1991; 66: 687-693
Article info
Publication history
Published online: November 14, 2011
Received in revised form:
August 22,
2011
Received:
April 18,
2011
Footnotes
Jonathan Tomasko was responsible for the collection of data and analysis, drafting of the article, and critical revision of the article; Eric Pauli was responsible for the conception and design, performance of procedures, and critical revision of the article; Allen Kunselman was responsible for the statistical analysis; and Randy Haluck was responsible for the conception and design and critical revision of the article.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
