Medical Resident Driving Simulator Performance Following a Night on Call

This study compared driving simulation performance after night call and after being off call in 22 medical residents and 1 medical student in a prospective within-subjects counterbalanced design. The results demonstrated an unexpected interaction between call and sex wherein men performed more poorly after night call than women as measured by lane variance and crash frequency. Secondary measures, including caffeine, actigraphy, and subjective total sleep time, did not differ between men and women. Collectively, results of this study and others suggest that medical residents are at risk when driving after a night on call and support the need for resident education to address sleep needs, consequences of sleep disruption, postcall recovery sleep, and countermeasures that may reduce residents' driving risks.

[1]  J. Samkoff,et al.  A review of studies concerning effects of sleep deprivation and fatigue on residents' performance , 1991, Academic medicine : journal of the Association of American Medical Colleges.

[2]  M. Johns,et al.  Sleepiness in different situations measured by the Epworth Sleepiness Scale. , 1994, Sleep.

[3]  Andy H. Lee,et al.  Assessing the driving performance of older adult drivers: on-road versus simulated driving. , 2003, Accident; analysis and prevention.

[4]  C. Marcus,et al.  Effect of sleep deprivation on driving safety in housestaff. , 1996, Sleep.

[5]  F. Wolf,et al.  WORKING CONDITIONS AND ADVERSE PREGNANCY OUTCOME: A META‐ANALYSIS , 2000, Obstetrics and gynecology.

[6]  T. Åkerstedt,et al.  Impaired alertness and performance driving home from the night shift: a driving simulator study , 2005, Journal of sleep research.

[7]  E. Bixler,et al.  Adverse effects of modest sleep restriction on sleepiness, performance, and inflammatory cytokines. , 2004, The Journal of clinical endocrinology and metabolism.

[8]  R. Muelleman,et al.  The occupational risk of motor vehicle collisions for emergency medicine residents. , 1999, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[9]  R. Vorona,et al.  Overweight and obese patients in a primary care population report less sleep than patients with a normal body mass index. , 2005, Archives of internal medicine.

[10]  Kowalenko,et al.  Emergency medicine resident related auto accidents-Is sleep deprivation a risk factor? , 2000, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[11]  C. Lyttle,et al.  Impact of the Libby Zion case on graduate medical education in internal medicine. , 1998, The Mount Sinai journal of medicine, New York.

[12]  J. Gravenstein,et al.  The effect of fatigue on the performance of a simulated anesthetic monitoring task , 2004, Journal of Clinical Monitoring.

[13]  F G Freeman,et al.  Driving simulation with EEG monitoring in normal and obstructive sleep apnea patients. , 2000, Sleep.

[14]  M. Johns,et al.  Daytime sleepiness and sleep habits of Australian workers. , 1997, Sleep.

[15]  M. Skaredoff,et al.  Residents' performance before and after night call as evaluated by an indicator of creative thought , 1995, The Journal of the American Osteopathic Association.

[16]  K. Strohl,et al.  The Effects of Sleep Loss and Fatigue on Resident–Physicians: A Multi-Institutional, Mixed-Method Study , 2004, Academic medicine : journal of the Association of American Medical Colleges.

[17]  T. Young,et al.  Epidemiology of daytime sleepiness: definitions, symptomatology, and prevalence. , 2004, The Journal of clinical psychiatry.

[18]  G Jean-Louis,et al.  Assessment of physical activity and sleep by actigraphy: examination of gender differences. , 1999, Journal of women's health & gender-based medicine.

[19]  M. Greenwald,et al.  Risk-taking behavior: effects of ethanol, caffeine, and basal sleepiness. , 2004, Sleep.

[20]  J A Kwentus,et al.  Effect of sleep deprivation on first-year residents' response times, memory, and mood. , 1987, Journal of medical education.

[21]  F. Speizer,et al.  Extended work shifts and the risk of motor vehicle crashes among interns. , 2005, The New England journal of medicine.

[22]  Christopher Drake,et al.  Ethanol and sleep loss: a "dose" comparison of impairing effects. , 2003, Sleep.

[23]  B. Barzansky,et al.  Sleep loss and fatigue in residency training: a reappraisal. , 2002, JAMA.

[24]  Barbara Freund,et al.  Evaluating Driving Performance of Cognitively Impaired and Healthy Older Adults: A Pilot Study Comparing On‐Road Testing and Driving Simulation , 2002, Journal of the American Geriatrics Society.

[25]  M. B. Walker,et al.  Cognitive performance and mood after a weekend on call in a surgical unit , 1997, The British journal of surgery.

[26]  D. Baldwin,et al.  Learning, satisfaction, and mistreatment during medical internship: a national survey of working conditions. , 1998, JAMA.

[27]  D. Dawson,et al.  Fatigue, alcohol and performance impairment , 1997, Nature.

[28]  M. Klebanoff,et al.  Outcomes of Pregnancy in a National Sample of Resident Physicians , 1990, The New England journal of medicine.