Sleep Deprivation Adversely Impacts Resident Performance for Simulated Arthroscopy

Quentin Baumann, Yassine Bulaid, Axel Van Vliet, Antoine Gabrion, Céline Klein, Patrice Mertl, Quentin Baumann, Yassine Bulaid, Axel Van Vliet, Antoine Gabrion, Céline Klein, Patrice Mertl

Abstract

Purpose: The purpose of the study was to assess the performance of residents in orthopaedics before and after a 24-hour shift on a shoulder arthroscopy simulator. The primary study endpoint was an overall performance score (OPS) generated by the simulator.

Methods: A prospective, comparative study of 120 simulator trials by 10 resident junior surgeons was performed in our university hospital's simulation center between May and November 2018. To avoid memorization bias, all participants performed the same exercise 10 times on a VirtaMed ArthroS simulator prior to the study. Each resident's performance (the OPS, the operating time, the proportion of procedures with iatrogenic lesions, the camera path length and the hook path length) in two different simulated arthroscopy exercise tasks was assessed once before and once after a 24-hour shift. This sequence was performed three times during the semester, and the change over time in performance was also evaluated.

Results: The OPS was significantly lower after the night shift (P = 0.035 for the first exercise, and P = 0.025 for the second).

Conclusion: In a group of previously trained resident junior surgeons, overall performance with an arthroscopy simulator was significantly worse after a 24-hour shift. The study of secondary parameters of the OPS and the subgroup analysis based on the sleep time and Epworth score vary depending on the type of exercise performed arthroscopically. However, the use of a simulator after a night shift did not prevent the trainee from improving his/her level of performance over time.

Level of evidence: II, a prospective, comparative study.

© 2021 by the Arthroscopy Association of North America. Published by Elsevier Inc.

Figures

Fig 1
Fig 1
Change over time in the mean OPS for the CTS exercise, before (1, 2, 3) and after (1’, 2’, 3’) the shift (three sessions).
Fig 2
Fig 2
Change over time in the mean OPS for the SD exercise, before (1, 2, 3) and after (1’, 2’, 3’) the shift (three sessions).

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Source: PubMed

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