Cognitive Performance After a Night Shift in Internal Medicine Residents

Study Overview
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Brief Summary
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A quasi-experimental design where internal medicine residents in a high complexity hospital were assessed after a 24-hour shift for cognitive impairment by a trained neurologist.

Detailed Description
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The investigators conducted a cross sectional study during the 2014-2016 period in a high complexity school hospital in Buenos Aires. Second and third year Internal Medicine residents who consented to participate were included. A neurologist conducted a cognitive evaluation to the residents who had done 24 hours shifts (with sleep deprivation) within 6 hours of its end. Auditory memory deficit was evaluated (PASAT - Paced Auditory Serial Addition Test), verbal fluency (FAS), direct and indirect Digit-Span, Rey auditory verbal learning test (RAVLT) and Continuous Performance Test 2 (CPT2). Results were presented as means of standardized scores (z score) with their interquartile range (IQR).

Official Title
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Evaluation on the Effect on Cognition and Emotional Exhaustion With a Change of Long Night Shift System Versus Reduced Night Shift in Residents of Internal Medicine

Conditions
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Sleep Deprivation, Burnout, Professional, Cognition Disorders

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Internal Medicine residents on the second or third year of formation. Exclusion Criteria: Denial to participate in the study or to the informed consent.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neurological evaluation using Paced Auditory Serial Addition Test (PASAT) | Post on-call cognition assessment | Immediately after a 24 hours on call period, wth a maximum delay of 6 hours after night shift end. | 
| Burn Out | Maslach questionaire filled by participant | through study completion, an average of one year | 
| Conners Continuous Performance Test 2 (CPT) | Post on-call attention test | Immediately after a 24 hours on call period, wth a maximum delay of 6 hours after night shift end. | 
| Rey auditory verbal learning test (RAVLT) | Post on-call cognition assessment | Immediately after a 24 hours on call period, wth a maximum delay of 6 hours after night shift end. | 
| F-A-S test | Post on-call verbal fluency | Immediately after a 24 hours on call period, wth a maximum delay of 6 hours after night shift end. | 
| Direct and indirect digit span | Post on-call short-term verbal memory | Immediately after a 24 hours on call period, wth a maximum delay of 6 hours after night shift end. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depression | Questionaire filled by participant | through study completion, an average of one year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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sleep deprivation, internal medicine residency, on call, cognitive impairment, burn out, safety, depression