@article{12662,
  author = {Vineet Arora and Emily Georgitis and Juned Siddique and Ben Vekhter and James N. Woodruff and Holly J. Humphrey and David O. Meltzer},
  title = {Association of workload of on-call medical interns with on-call sleep duration, shift duration, and participation in educational activities.},
  abstract = {<p><b>CONTEXT: </b>Further restrictions in resident duty hours are being considered, and it is important to understand the association between workload, sleep loss, shift duration, and the educational time of on-call medical interns.</p><p><b>OBJECTIVE: </b>To assess whether increased on-call intern workload, as measured by the number of new admissions on-call and the number of previously admitted patients remaining on the service, was associated with reductions in on-call sleep, increased total shift duration, and lower likelihood of participation in educational activities.</p><p><b>DESIGN, SETTING, AND PARTICIPANTS: </b>Prospective cohort study of medical interns at a single US academic medical center from July 1, 2003, through June 24, 2005. Of the 81 interns, 56 participated (69%), for a total of 165 general medicine inpatient months resulting in 1100 call nights.</p><p><b>MAIN OUTCOME MEASURES: </b>On-call sleep duration, estimated by wrist watch actigraphy; total shift duration, measured from paging logs; and participation in educational activities (didactic lectures or bedside teaching), measured by experience sampling method via a personal digital assistant.</p><p><b>RESULTS: </b>Mean (SD) sleep duration on-call was 2.8 (1.5) hours and mean (SD) shift duration was 29.9 (1.7) hours. Interns reported spending 11% of their time in educational activities. Early in the academic year (July to October), each new on-call admission was associated with less sleep (-10.5 minutes [95% confidence interval {CI}, -16.8 to -4.2 minutes]; P < .001) and a longer shift duration (13.2 minutes [95% CI, 3.2-23.3 minutes]; P = .01). A higher number of previously admitted patients remaining on the service was associated with a lower odds of participation in educational activities (odds ratio, 0.82 [95% CI, 0.70-0.96]; P = .01]. Call nights during the week and early in the academic year were associated with the most sleep loss and longest shift durations.</p><p><b>CONCLUSION: </b>In this study population, increased on-call workload was associated with more sleep loss, longer shift duration, and a lower likelihood of participation in educational activities.</p>},
  year = {2008},
  journal = {JAMA},
  volume = {300},
  pages = {1146-53},
  month = {09/2008},
  issn = {1538-3598},
  doi = {10.1001/jama.300.10.1146},
  language = {eng},
}