Call- Associated Acute Fatigue in Surgical Residency

Study Overview
=================
Brief Summary
-----------------
The study aimed to evaluate the effects of 24-Hour-Call-associated acute partial sleep deprivation on surgical residents' technical and cognitive performance in a virtual reality (VR) setting. Physiological parameters were used to quantify fatigue in respect to hours of sleep and subjective degrees of sleepiness. Technical performance and cognitive skills were assessed through low- and high fidelity tasks usig the VR- simulator LapSim. Objective alertness was measured by the standardized d2-Paper-Pencil-Test. Cited assessments were performed on three consecutive mornings- pre- and post-call as after 24 hours resting.

Detailed Description
-----------------
Summary Background Data: The effect of acute partial sleep deprivation on surgical proficiency is still controversially discussed. The present study is the first to measure objective physiological parameters of fatigue in respect to subjective perceptions of sleepiness in VR- research of surgical performance. Methods: 38 surgeons were explored on three consecutive mornings: prior to a 24-Hour- Call, post-call and after 24 hours resting. Hours of sleep were recorded. Subjective alertness was assessed using the standardized Stanford-Sleepiness-Scale (SSS). Saliva cortisol concentrations and pupillary activity were measured by ELISA and pupillography. The VR-simulator LapSim® was used to assess technical skills through defined low- fidelity VR-tasks cutting, clip applying and cognitive skills through defined high-fidelity VR-tasks intracorporal suturing, VR-cholecystectomy. Objective alertness was measured by the standardized d2-Paper-Pencil-Test.

Official Title
-----------------
Call-associated Acute Fatigue in Surgical Residency- Subjective Perception or Objective Fact?

Conditions
-----------------
Sleep Deprivation

Intervention / Treatment
-----------------
* Other: 24-Hour-Call


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Surgical interns, junior- or senior residents Successful completion of a minimum of 10 basic VR- tasks with the VR- simulator LapSim: camera navigation, coordination, clip applying, Cutting, and diathermy cutting and a minimum of 5 sessions of advanced VR- tasks: fine dissection, intracorporal suturing and VR- cholecystectomy Voluntary participation Written informed consent Exclusion Criteria: Lack of required VR- training Lack of informed consent

Ages Eligible for Study
-----------------
Minimum Age: 28 Years
Maximum Age: 50 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: 24-Hour-Call|one 24-Hour-Call within the regular surgical schedule|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Technical and cognitive performance | Technical and cognitive performance was assessed in a VR-setting of defined parameters of performance and the d2-Paper-Pencil-Test on three consecutive mornings- pre- and post call and after 24 hours resting. | 3 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sleepiness and Fatigue | Sleepiness was assessed by Stanford Sleepiness Sclae (SSS) and fatigue was measured through pupillography and saliva cortisol concentration on three consecutive mornings- pre- and post call and after 24 hours resting. | 4 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
sleep-deprivation, virtual reality, residency, performance