Studies of sleep deprivation show that for most people the effects can be as severe as those of alcohol
intoxication. Definitely don’t try to fly a plane if you haven’t slept.
Counterintuitively, surgeons seem to function quite well when they’ve been on call
all night. According to a study run by Jonathan Tomasko and his colleagues from
Penn State College of Medicine, sleep-deprived surgical students performed just
as well as their rested cohorts.
A group of medical students were
set to work at a simulator learning techniques that would be used during
laparoscopic surgeries. Once the students were declared proficient at the
simulators, the real tests began.
Before the first day of testing,
all participants were asked to get a full night’s sleep. They were then put
through the simulator’s paces, but this time with an added difficulty. Besides
pretending to probe and suture, the students also had to keep track of how many
times a yellow disk had appeared in the corner of the screen.
After the first day, half the
students were sent home to another good night’s sleep (control), and the other
half were kept up all night (sleep-deprived). The next day, both groups
repeated the same simulator exercises. Once this was done, they were presented with a brand new simulator that they also had to learn to use.
The students completed
self-assessment tests of their sleepiness at the start of each testing day. Not
surprisingly, the sleep-deprived group reported that they were much more tired
than the control group. Nevertheless, both groups managed their simulators
equally well. The sleep deprived students did feel like the tasks were taking a
lot longer and were more difficult than the control students did, but they were
able to learn to use the new simulator just as proficiently as the control
students.
This is interesting and very reassuring. I know that I actually become a better writer when I'm sleep deprived. That may simply be due to a slight loss of inhibitions.
ReplyDeleteThere have been changes in residency programs over the past 15 years to make them more "humane". So now there are limits to the number of hours they can be on duty and some programs limit the number of patients they can see in a day. This may seem like a good idea, a well rested physician will make better decisions. However, coming from the "old school" where we would be on 36 hours straight every 3 days. I believe it made me a better physician. I was "forced" to think faster, maintain professionalism under high stress situations like a "code" situation, etc. Going through this type a training was almost a rite of passage and made us stronger and better physicians.
ReplyDeleteI see new grads coming out of training expecting to work 32-36 hour weeks, no night call, no weekends, etc. There is a whole new generation of doctors that come out of training that refuse to do any hospital work; they only want to see patients in the clinic and if their patient needs to be hospitalized, the case will be handed off to a "hospitalist". Any outpatient case that seem a bit complicated gets referred to a specialist. I wouldn't go so far as calling them lazy but they certainly don't work as hard as my generation of docs.
So my vote is to bring back the Old School Training, now we have research to back this up.
Thank you for giving your perspective. That was very interesting.
DeleteThank you for giving your perspective. That was very interesting.
DeleteWhy did it post my reply twice? I must have REALLY found it interesting.
ReplyDelete