Highlights
- •Transplant surgery fellows experience frequent sleep deprivation.
- •Biophysiological stress is prevalent among abdominal transplant surgery fellows.
- •Transplant surgery fellows are often non-compliant with policies created to reduce burnout.
Abstract
Background
Transplant surgery fellowship is physically and emotionally demanding. The objective
of this study was to characterize biophysiological stress and sleep patterns among
transplant surgery fellows.
Methods
Participating fellows wore a biophysical monitor over a 28-day period and completed
biweekly surveys. Sleep patterns were dichotomized as normal or sleep deprived, and
heart rate variability (HRV) was used to assess stress.
Results
Seventeen fellows participated. Fellows were frequently sleep deprived (43.9% of nights)
and stress was near universal (87.2% of days). Burnout was reported by 2 fellows (11.8%).
Only 4 fellows (23.5%) reported compliance with the Transplant Accreditation and Certification
Council managed time policy; these fellows experienced fewer days of stress than non-compliant
fellows (79.8% vs 89.2% p = 0.02).
Conclusions
This is the first study to quantify sleep deprivation and stress among transplant
fellows. Future work is needed to evaluate the effects of sleep deprivation, and stress
on burnout and patient outcomes.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A national study of burnout among American transplant surgeons.Transplant Proc. 2005; 37: 1399-1401
- Extinguishing burnout: national analysis of predictors and effects of burnout in abdominal transplant surgery fellows.Am J Transplant. 2021; 21: 307-313
- Transplant surgery pipeline: a report from the American society of transplant surgeons pipeline taskforce.J Am Coll Surg. 2021; 233: 262-271
- Surgeon distress as calibrated by hours worked and nights on call.J Am Coll Surg. 2010; 211: 609-619
- To sleep, perchance to dream: acute and chronic sleep deprivation in acute care surgeons.J Am Coll Surg. 2019; 229: 166-174
- National survey of burnout among US general surgery residents.J Am Coll Surg. 2016; 223: 440-451
- Orthopaedic surgeon physiological indicators of strain as measured by a wearable fitness device.J Am Acad Orthop Surg. 2021; 29: e1378-e1386
- Physiologic stress among surgeons who take in-house call.Am J Surg. 2019; 218: 1181-1184
- Resident burnout.JAMA. 2004; 292: 2880-2889
- Burnout and medical errors among American surgeons.Ann Surg. 2010; 251: 995-1000
- Assessment of physician sleep and wellness, burnout, and clinically significant medical errors.JAMA Netw Open. 2020; 3: e2028111
- Principles and Practice of Sleep Medicine.fourth ed. Elsevier/Saunders. xxxiii, Philadelphia, PA2005: 1517
- Sleep deprivation and neurobehavioral dynamics.Curr Opin Neurobiol. 2013; 23: 854-863
- Sleep loss and fatigue in residency training: a reappraisal.JAMA. 2002; 288: 1116-1124
- Autonomic dysregulation in burnout and depression: evidence for the central role of exhaustion.Scand J Work Environ Health. 2017; 43: 475-484
- Heart rate variability as a strain indicator for psychological stress for emergency physicians during work and alert intervention: a systematic review.J Occup Med Toxicol. 2021; 16: 24
- Heart rate variability in different levels of burnout-cross-sectional study of different occupational groups heart rate variability and burnout.J Occup Environ Med. 2021; 63: e622-e630
- An overview of heart rate variability metrics and norms.Front Public Health. 2017; 5: 258
- Psychophysiological biomarkers of workplace stressors.Neurosci Biobehav Rev. 2010; 35: 51-57
- Fellowship time managed policy.(Available from:)
- Exploring the relationship between burnout and grit during general surgery residency: a longitudinal, single-institution analysis.Am J Surg. 2020; 219: 322-327
- The impact of medical student burnout on surgery clerkship performance.J Surg Educ. 2019; 76: 1241-1247
- Effect of wearables on sleep in healthy individuals: a randomized crossover trial and validation study.J Clin Sleep Med. 2020; 16: 775-783
- Validation of photoplethysmography-based sleep staging compared with polysomnography in healthy middle-aged adults.Sleep. 2017; 40
- Heart rate variability: an old metric with new meaning in the era of using mHealth technologies for health and exercise training guidance. Part One: physiology and methods.Arrhythmia Electrophysiol Rev. 2018; 7: 193-198
- A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health.Neurosci Biobehav Rev. 2012; 36: 747-756
- Distress and career satisfaction among 14 surgical specialties, comparing academic and private practice settings.Ann Surg. 2011; 254: 558-568
- Behavioral and physiological consequences of sleep restriction.J Clin Sleep Med. 2007; 3: 519-528
- Association of physician burnout with suicidal ideation and medical errors.JAMA Netw Open. 2020; 3e2028780
- Maslach Burnout Inventory Manual.third ed. Consulting Psychologists Press. iv, Palo Alto, Calif1996: 52 (577 College Ave., Palo Alto 94306)
Article info
Publication history
Published online: November 08, 2022
Accepted:
November 4,
2022
Received in revised form:
September 20,
2022
Received:
June 29,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
