Improving Doctors' Working Lives

Patient safety and clinical error / General performance / Health risks / Fatigue and driver safety / Night shift alertness and napping / Attitudes and experiences / New ways of working / Training implications / Other useful papers

Night work, fatigue and performance

Jakubowicz DM. et al (2005) 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 115(1):143-6.

Bailit JL., Blanchard MH. (2004) The effect of house staff working hours on the quality of obstetric and gynecologic care. Obstet Gynecol. Apr;103(4):613-6

Ellman PI. et al (2004) Sleep deprivation does not affect operative results in cardiac surgery. Ann Thorac Surg 78(3):906-11.

Jensen A. et al (2004) Short-term sleep deficits do not adversely affect acquisition of laparoscopic skills in a laboratory setting. Surg Endosc. Jun;18(6):948-53

Landrigan C. et al (2004) Effect of reducing interns' work hours on serious medical errors in intensive care units. N Engl J Med. 351:1838-48.

Mak SK., Spurgeon P. (2004) The effects of acute sleep deprivation on performance of medical residents in a regional hospital: prospective study. Hong Kong Med J. 10(1):14-20.

Rogers AE. et al (2004) The Working Hours Of Hospital Staff Nurses And Patient Safety. Health Aff (Millwood). Jul-Aug;23(4):202-12.

The Accreditation Council for Graduate Medical Education (2003): Selected Articles on Resident and Physician Work Hours.

Gaba & Howard (2002) Fatigue among clinicians and the safety of patients. New Engl J Med 347:1249-1255.

Grantcharov T. et al (2001) Laparoscopic performance after one night on call in a surgical department: prospective study. BMJ. November 24; 323 (7323): 1222–1223.

Jha, A.K. et al (2001) "Fatigue, Sleepiness and Medical Errors". In: Making Health Care Safer: A Critical Analysis of Patient Safety Practices. Evidence Report/Technology Assessment: Number 43. AHRQ Publication No. 01-E058, July 2001. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/ptsafety/.

Implications for health and safety of junior doctors working arrangements (BMA website)

Matthews M.L. et al (2006) Post-call cognitive function and satisfaction in medical students on different call schedules: A prospective observational pilot study. Am J Obstet Gynecol. Jun 20 [epub ahead of print].

Coburn M. et al (2006) Influence of a 30-min break on divided attention and working memory in resident anaesthetists on daily routine. Br J Anaesth. Jun 21 [epub ahead of print].

Bartel P. et al (2004) Attention and working memory in resident anaesthetists after night duty: group and individual effects. Occup Environ Med 61(2):167-70.

Philip P. et al. (2004) Age, performance and sleep deprivation. J Sleep Res. Jun;13(2):105-10.

Roehrs T., Greenwald M., Roth T. (2004) Risk-Taking Behavior: Effects of Ethanol, Caffeine, and Basal Sleepiness Sleep 27:887-93.

Wagner U. et al (2004) Sleep inspires insight. Nature. 427(6972):352-5.

Dawson D. & Reid K. (1995) Fatigue, alcohol and performance impairment. Nature. 388(6639):235.

Chien LY., Ko YL. (2004) Fatigue during pregnancy predicts caesarean deliveries. J Adv Nurs. Mar;45(5):487-94

Dmitri V. et al (2004) Effect of the 80-Hour Workweek on Resident Burnout. Arch Surg. 139:933-940.

Zare SM. et al (2004) Psychological well-being of surgery residents before the 80-hour work week: a multiinstitutional study. J Am Coll Surg. Apr;198(4):633-40

Akerstedt T. (2005) Impaired alertness and performance driving home from the night shift: a driving simulator study. J Sleep Res 14(1):17-20.

Steier S. et al (2003) Driver drowsiness--are physicians at a special risk? Harefuah 2003;142(5):338-41, 399, 398.

Schweitzer P.K. et al (2006) Laboratory and field studies of naps and caffeine as practical countermeasures for sleep-wake problems associated with night work. Sleep. Jan 1;29(1):39-50.

Murray, A. et al (2005) Junior doctors' hours and sleep deprivation. BMJ 330(7505):1404. Summary available in the IDWL archive.

Bonnefond A. et al (2004) A critical review of techniques aiming at enhancing and sustaining workers' alertness during the night shift. Ind Health. 42(1):1-14.

Hayashi M. et al (2004) Short nap versus short rest: recuperative effects during VDT work. Ergonomics 47(14):1549-60.

Morton JM. et al (2004) What do surgery residents do on their call nights? Am J Surg. Sep;188(3):225-9.

Ferrara M. & De Gennaro L. (2000) The Sleep Inertia Phenomenon During the Sleep-Wake Transition: Theoretical and Operational Issues. Aviat Space Environ Med. 71:843-8.

Attitudes and experiences

Hutter M.M. et al (2006) The impact of the 80-hour resident workweek on surgical residents and attending surgeons. Ann Surg. 243(6):864-71; discussion 871-5.

Lockley S.W. et al (2006) When policy meets physiology: the challenge of reducing resident work hours. Clin Orthop Relat Res. Jun 8 [epub ahead of print].

Friedman WA. (2004) Resident duty hours in American neurosurgery. Neurosurgery. Apr;54(4):925-31; discussion 931-3.

Jagsi R., Surender R. (2004) Regulation of junior doctors' work hours: an analysis of British and American doctors' experiences and attitudes. Soc Sci Med. Jun;58(11):2181-91.

Lamberg L. (2004) Should Sleep-Starved Residents Be Setting Off Alarms? Psych News 39:15 (August 6)

DeWitt C. et al (2003) A National Survey of Residents' Self-Reported Work Hours: Thinking Beyond Specialty. Academic Medicine 78: 1154-1163.

Feyer (2001) Fatigue: time to recognise and deal with an old problem (It's time to stop treating lack of sleep as a badge of honour) BMJ. 322:808-809 (7 April).

Pickersgill (2001) The European working time directive for doctors in training.
BMJ. 323:1266 (1 December).

Olson & Ambrogetti (1998)Working harder - working dangerously? Med J Aust. 168: 614-616.

Nocera & Khursandi (1998) Doctors' working hours: can the medical profession afford to let the courts decide what is reasonable? Med. J Aust. 168: 616-618.

Holmes (1998)Junior doctors' working hours: an unhealthy tradition? Editorial Med J Aust. 168: 587-588.

(1994) United States limits resident physicians to 80 hour working week. BMJ. 326:468 (1 March).

New ways of working

Goldstein MJ. et al (2004) A 360 degrees evaluation of a night-float system for general surgery: A response to mandated work-hours reduction. Curr Surg. 61(5):445-51.

Lissauer R. (2002) The future workforce. BMJ. 325:S73 (7 September)

Hutchinson L. et al (2001) The physician assistant: would the US model meet the needs of the NHS? BMJ. 323:1244-1247 (24 November)

Sakr M. et al (1999) Care of minor injuries by emergency nurse practitioners or junior doctors: a randomised controlled trial. Lancet. 354(9187):1321-6.

Working hours and training implications

Carver (2003) The impact of restrictions in the hours of work of doctors in training on service delivery and education. Internet: Health Workforce Australia.

Whymark C. et al (2006) A Scottish National Prospective Study of airway management skills in new-start SHOs. Br. J. Anaesth. August 1.

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