The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index; 1 of the 25 sources its claims cite were checked for support.
Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures
Open accessAbstract
Background Knowledge of the physiological effects of extended (24 hours or more) work shifts in postgraduate medical training is limited. We aimed to quantify work hours, sleep, and attentional failures among first-year residents (postgraduate year 1) during a traditional rotation schedule that included extended work shifts and during an intervention schedule that limited scheduled work hours to 16 or fewer consecutive hours. Methods Twenty interns were studied during two three-week rotations in intensive care units, each during both the traditional and the intervention schedule. Subjects completed daily sleep logs that were validated with regular weekly episodes (72 to 96 hours) of continuous polysomnography (r=0.94) and work logs that were validated by means of direct observation by study staff (r=0.98). Results Seventeen of 20 interns worked more than 80 hours per week during the traditional schedule (mean, 84.9; range, 74.2 to 92.1). All interns worked less than 80 hours per week during the intervention schedule (mean, 65.4; range, 57.6 to 76.3). On average, interns worked 19.5 hours per week less (P Conclusions Eliminating interns' extended work shifts in an intensive care unit significantly increased sleep and decreased attentional failures during night work hours.
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The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“The increased incidence of attentional failures during night work among interns during the traditional as compared with the intervention schedule may impede their ability to care for patients and their education.27 , 37”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
What the sources say
- Could not verifycites [27] sourceExperimental — accuracy not yet measured
The Results and Discussion passages (page not provided) concern sleep-dependent motor-skill learning, not interns’ night work. Searches for attentional failures, traditional versus intervention schedules, patient care, and interns’ education found no passage addressing the claim. (LLM, conf=0.75)
- Not checked — no full text of the sourcecites [37] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Could not verify
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The traditional schedule had three times as many shifts that were prefaced by fewer than 2 hours of sleep in the preceding 24 hours and more than twice as many attentional failures during night work as did the intervention schedule.”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Furthermore, during both the traditional and the intervention schedule, reported work hours often exceeded both the scheduled weekly hours and the number of consecutive work hours scheduled, owing to the interns' obligation to ensure the continued care of their patients after their own shift was over.”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and 1.5 times the rate during the day (7 a.m. to 10 p.m.) (P=0.07).”
- Also stated in: § attentional failures · hedged
“a trend (P=0.07)toward a reduction in attentional failures during day and evening call (7 a.m. to 10 p.m.) was also apparent”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Also stated in: § attentional failures · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“slept more in the 24 hours preceding each working hour (P<0.001)”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All interns worked less than 80 hours per week during the intervention schedule (mean, 65.4; range, 57.6 to 76.3).”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > results
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The percentage of work hours preceded by more than 8 hours of sleep in the prior 24 hours was 17 percent during the traditional schedule and 33 percent during the intervention schedule (P<0.001)”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > duration of work and sleep
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“with 21 percent of these work hours logged after more than 24 hours of continuous duty.”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > work hours
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Attentional failures occurred at more than double the rate during the night (from 11 p.m. to 7 a.m.) on the traditional schedule as compared with the intervention schedule (P=0.02)”
- Also stated in: § attentional failures · plain
“more than twice as many attentional failures during night work as did the intervention schedule.”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § attentional failures · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On average, interns worked 19.5 hours per week less (P<0.001)”
- Also stated in: § work hours · plain
“All 20 interns worked longer during the traditional schedule (mean, 84.9±4.7 hours per week; range, 74.2 to 92.1) than during the intervention schedule (mean, 65.4±5.4hours per week; range, 57.6 to 76.3; P<0.001)”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § work hours · plain
- It may state two separate claims as one. 17
- Probably not a substantial claim. 7
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During the traditional schedule, 31 percent of work hours were preceded by 4 or fewer hours of sleep in the preceding 24 hours and 19 percent of work hours were preceded by 2 or fewer hours of sleep in the previous 24 hours, as compared with 13 percent and 6 percent, respectively, during the intervention schedule (P<0.001 for both comparisons)”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > duration of work and sleep
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On average, interns slept for 1.76±1.04hours between 9 p.m. and 8 a.m. during the traditional schedule, significantly longer than they slept while working the corresponding hours during the intervention schedule (1.29±0.90hours per shift, P=0.02).”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > duration of work and sleep
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The weekly durations of sleep and work were significantly inversely correlated (r=¡0.57,P<0.001), with a predicted loss of 19.2 minutes of sleep per week for each additional hour of work per week (Fig. 3C).”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > duration of work and sleep
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The intervention schedule had no extended work shifts (Fig. 4B), and 96 percent of work hours occurred within the 16 hours scheduled, in contrast to the traditional schedule, in which only 58 percent of work hours occurred within the first 16 hours on duty.”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > work hours
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During the traditional rotation, over half of work shifts (133 of 223, or 60 percent) were extended (more than 24 hours) and 84 percent of work hours (4255 of 5036) occurred during these shifts”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > work hours
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“he accreditation council for Graduate Medical Education (ACGME) has recently limited work hours for U.S. medical residents to less than 320 hours in a four-week period, with up to 32 additional hours for programs granted exceptions. 1”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > results
What the sources say
- Not matchedcites [1] Common program requirements (resident duty hours). Chicago: Accreditation Council for Graduate Medical Education, February 2003. (Accessed October 4, 2004, at http://www.acgme.org/DutyHours/dutyHoursCommonPR.pdf.)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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In the paper
“considering the fact that caffeine use, compliance with the protocol, and individual differences in the need for sleep among subjects could not be controlled in this field study.”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our findings may apply not only to residents working in critical care units but also to those on other rotations and specialties and to more senior residents, attending physicians, nurses, and others.”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
Strength:hedged· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“It is noteworthy that interns took prophylactic naps before two thirds of the overnight shifts during the intervention schedule, thereby preemptively attenuating the deleterious effects on alertness and neurobehavioral performance of continuous wakefulness and blunting the circadian performance nadir.38”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
What the sources say
- Not matchedcites [38] Jewett ME. Models of circadian and homeostatic regulation of human performance and alertness. (Ph.D. thesis. Cambridge, Mass.: Harvard University, 1997.)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This sizable and unidentified proportion of the population may be particularly vulnerable to the effects of extended work shifts and chronic sleep restriction imposed during residency training, possibly unwittingly placing themselves and their patients at markedly increased risk for fatigue-related errors.”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes? Checkable: unclear? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Slow eye movements are correlated with performance failures on the psychomotor vigilance task 21 and are reduced by treatments that counteract fatigue and thus improve neurobehavioral performance.[34][35][36]”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
What the sources say
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The number of slow eye movements recorded during all waking polysomnographic epochs was determined by a single scorer according to established criteria in an unblinded fashion.21 Results were then validated in a blinded fashion by an independent scorer who compared them with the rates recorded from 9 p.m. to 3 p.m. in a subgroup (10 percent) of EOG recordings (r=0.94,P<0.001).”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional-failure measurements
What the sources say
- Not checked — no full text of the sourcecites [21] Cajochen C, 1999, Am J Physiol source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our data on actual work hours reveal that the max-imal number of scheduled work hours must be much lower to allow for this inevitability.”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Using a within-subjects design, we studied 20 interns during two three-week rotations in the medical intensive care unit (MICU) and coronary care unit (CCU) while they followed a traditional schedule with extended work shifts of 30 consecutive hours scheduled every other shift and an intervention schedule in which work shifts were a maximum of 16 consecutive hours scheduled.”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > coverage schedules
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“The presence of slowrolling eye movements during wakefulness is indicative of profound fatigue in both occupational settings 29 and laboratory settings 21 and parallels subjective sleepiness, theta activity on electroencephalography, and impaired neurobehavioral performance 21,29”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
What the sources say
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“we believe it unlikely that simply decreasing the number of hours worked in a week without incorporating the underlying principles of sleep physiology would yield a similar increase in sleep or reduction in attentional”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Our study provides objectively validated data on work hours, sleep, and attentional failures among medical trainees in situ and quantifies the effects of eliminating extended work shifts on these measures.”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Eliminating interns' extended work shifts in an intensive care unit significantly increased sleep and decreased attentional failures during night work hours.”
- Also stated in: § attentional failures · plain
“The elimination of extended work shifts had a significant effect on the number of hours worked by interns, the duration of sleep, and the rate of attentional failures.”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § attentional failures · plain
In the paper
“Since nearly a third of their work hours (31 percent) were thus preceded by 6 or fewer hours of sleep in the preceding 24 hours, they continued to carry a substantial sleep debt, accounting for the high residual rate of attentional failures on both schedules, even during the day.22”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > attentional failures
What the sources say
- Not checked — no full text of the sourcecites [22] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Subjective reports indicated that, before the new regulations were implemented, some trainees worked up to 140 hours per week, [12][13][14][15][16] although the validity of such reports has been questioned.3,17”
§ Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures > results
What the sources say
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper relies on this without support.
Knowledge of the physiological effects of extended (24 hours or more) work shifts in postgraduate medical training is limited.
“Knowledge of the physiological effects of extended (24 hours or more) work shifts in postgraduate medical training is limited.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“A randomised controlled trial found that limiting first-year resident physicians to 16 consecutive work hours significantly improved resident alertness and patient safety.”
From National improvements in resident physician-reported patient safety after limiting first-year resident physicians’ extended duration work shifts: a pooled analysis of prospective cohort studies (2023) · cites this paper as [7]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Diaries were based on ones previously validated against the gold-standard for sleep assessment (polysomnography) in resident physicians55 and used in shift-workers56.”
From Irregular sleep/wake patterns are associated with poorer academic performance and delayed circadian and sleep/wake timing (2017) · cites this paper as [55]
In the citing paper
“Young children, being unmarried (19,26), working long hours (11,27,28), overweight and obesity (3-5), and measures of poor health (13,14,16,20,37,38,40) including acute and chronic respiratory conditions, pain, and anxiety increase the odds of short sleep and have a null or inverse association with long sleep.”
From Sleep Duration in the United States: A Cross-sectional Population-based Study (2009) · cites this paper as [11]
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Pilot Study Using Neurofeedback as a Tool to Reduce Surgical Resident Burnout
Kratzke, I. M., Campbell, A., Yefimov, M. N., Mosaly, P. R., Adapa, K., Meltzer-Brody, S. E., Farrell, T. M., & Mazur, L. M. (2020) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2020.08.762 · Cited by 18
Patient Safety in the Neonatal Intensive Care Unit
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Keating, R. J., LaRusso, N. F., & Kolars, J. C. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2005.04.014 · Cited by 18
Academic neonatologist—a species at the brink of extinction?
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“Extended work shifts (greater than 24 h) are associated with sleep deprivation and increased rates of medical and diagnostic errors compared to shifts of 16 h or less [10, 11].”
Background“Multivariate analysis of the impact of sleep and working hours on medical errors: a MICE approach"
Fedele, M. L. M., Gabeiras, M. D. P. L., Simonelli, G., Diez, J. J., Bellone, G., Cagliani, J. A., Larrateguy, L., Eiguchi, K., Golombek, D. A., Cardinali, D. P., et al. (2023) · BMC Public Health · doi:10.1186/s12889-023-17130-4 · Cited by 18
Jena, A. B., Schoemaker, L., & Bhattacharya, J. (2014) · Health Affairs · doi:10.1377/hlthaff.2014.0318 · Cited by 17
Assessing the Effects of the 2003 Resident Duty Hours Reform on Internal Medicine Board Scores
Silber, J. H., Romano, P. S., Itani, K. M. F., Rosen, A. K., Small, D. S., Lipner, R. S., Bosk, C. L., Wang, Y., Halenar, M. J., Korovaichuk, S., et al. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000193 · Cited by 17
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Surgical experience of neurosurgical residents in Europe: an alarming trend
Jakola, A. S., & Skoglund, T. S. (2019) · Acta Neurochirurgica · doi:10.1007/s00701-019-03889-2 · Cited by 17
Work and mental health in doctors: A short review of Norwegian studies
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Effect of Inadequate Sleep on Clinician Performance
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Assisting shift workers through sleep and circadian research
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Fatigue among anaesthesiologists in Europe
Podesta, A. M. C., Redfern, N., Abramovich, I., Mellin‐Olsen, J., Oremuš, K., Kouki, P., Guasch, E., Novak–Jankovič, V., Sabeļņikovs, O., Bilotta, F., et al. (2023) · European Journal of Anaesthesiology · doi:10.1097/eja.0000000000001923 · Cited by 17
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Blackwell, T., Kriesel, D. R., Vittinghoff, E., O’Brien, C. S., Sullivan, J. P., Viyaran, N. C., Rahman, S. A., Lockley, S. W., Barger, L. K., Halbower, A. C., et al. (2019) · Contemporary Clinical Trials · doi:10.1016/j.cct.2019.03.005 · Cited by 16
Self-citationEffect of shift work on fatigue and sleep in neonatal registrars
Anvekar, A. P., Nathan, E., Doherty, D. A., & Patole, S. (2021) · PLoS ONE · doi:10.1371/journal.pone.0245428 · Cited by 16
Real–Time Assessment of Nurse Work Environment and Stress
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“Sleep deprivation has been linked to medical errors in studies of physician groups (Landrigan et al., 2004; Lockley et al., 2004; Rosen, Gimotty, Shea, and Bellini, (2006); West, Tan, Habermann, Sloan, and Shanafelt (2009).”
BackgroundEmergency Medicine Resident Clinical Hours: A National Survey
Stowell, J. R., Vohra, T. T., & Luber, S. (2015) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2014.11.005 · Cited by 16
The Health-Related Quality of Life of Junior Doctors
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Klerman, E. B., Beckett, S. A., & Landrigan, C. P. (2016) · BMC Medical Education · doi:10.1186/s12909-016-0751-9 · Cited by 16
Self-citationA Bridge too Far: A Critique of the New ACGME Duty Hour Requirements
Alpert, J. S., & Frishman, W. H. (2011) · The American Journal of Medicine · doi:10.1016/j.amjmed.2011.10.002 · Cited by 16
“The results ave been contradictory with some studies showing fewer rrors with more mandated sleep time and one recent study howing increased length of stay and lower quality of care or patients with shorter duty shifts.(8,9,11) Over recent years, esident on-call duty hours spent in the hospital have been rogressively…”
BackgroundResultMedication Errors in Saudi Arabian Hospital Settings: A Systematic Review
Tobaiqy, M. A., & MacLure, K. (2024) · Medicina · doi:10.3390/medicina60091411 · Cited by 21
“[41,42,66].”
Bonhomme, V. L., Putensen, C., Böttiger, B. W., Stevens, M. F., Marczin, N., Arnal, D., Brotfain, E., Raz, A., Defresne, A., Bogossian, E. G., et al. (2024) · European Journal of Anaesthesiology Intensive Care · doi:10.1097/ea9.0000000000000063 · Cited by 15
Stress mindset and nurses’ sleep quality: mediating effects of stress overload and anxiety
Wu, Y., Guo, J., Liu, Q., Liu, J., Yu, T., Shen, Z., & Pan, X. (2024) · BMC Nursing · doi:10.1186/s12912-024-02474-y · Cited by 23
“Sleep deprivation can impair cognitive functions, negatively affecting decision-making, attention, and increasing the risk of medical errors, ultimately compromising patient safety [13].”
BackgroundSurgery Is in Itself a Risk Factor for the Patient
Aranaz-Ostáriz, V., de Castro, M. T. G. V., López-Rodríguez-Arias, F., Jose‐Saras, D. S., Vicente‐Guijarro, J., Pardo-Hernández, A., Andrés, J. M. A., & on behalf of the ESHMAD Director Group and External Advisers (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19084761 · Cited by 15
Mariños, A., Otero, M., Málaga, G., & Tomateo, J. (2012) · Revista Médica Herediana · doi:10.20453/rmh.v22i4.1071 · Cited by 15
“Genero M 30 (58,8) 20 (62,5) 0,73 F 21 (41,2) 12 (37,5) Pensó en retirarse de la residencia 18 (36,0) 21 (65,6) 0,009 Se encuentra conforme con la residencia 42 (84,0) 16(50,0) 0,001 Volvería a realizar la residencia 45 (90,0) 27 (87,1) 0,68”
BackgroundInfluentialSleep Science, Schedules, and Safety in Hospitals
Rosenbluth, G., & Landrigan, C. P. (2012) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2012.09.001 · Cited by 17
Self-citationRevisiting Persistent Neuronal Activity During Covert Spatial Attention
Amengual, J. L., & Hamed, S. B. (2021) · Frontiers in Neural Circuits · doi:10.3389/fncir.2021.679796 · Cited by 17
Legault, G. (2011) · Minerals · doi:10.3390/min1010049 · Cited by 16
Christmas, C., & Ziegelstein, R. C. (2009) · Teaching and Learning in Medicine · doi:10.1080/10401330902791362 · Cited by 15
Orthopaedic Residency Applications Increase After Implementation of 80-hour Workweek
Anakwenze, O. A., Kancherla, V. K., Baldwin, K. D., Levine, W. N., & Mehta, S. D. (2013) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-013-2785-1 · Cited by 15
Post-duty psychomotor performance in young and senior anaesthetists
Lederer, W., Kopp, M., Hahn, O., Kurzthaler, I., Traweger, C. M., Kinzl, J. F., & Benzer, A. (2006) · European Journal of Anaesthesiology · doi:10.1017/s0265021505002267 · Cited by 15
“It may increase attention failures by reducing peak mental abilities and response times [8,9] and, ultimately, fatigue may contribute to severe medical errors that affect patient safety [10–12].”
BackgroundFatigue Management in Safety-Critical Operations
Fletcher, A., Hooper, B., Dunican, I. C., & Kogi, K. (2015) · Reviews of Human Factors and Ergonomics · doi:10.1177/1557234x15573947 · Cited by 14
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Self-citationImpact of shift work on sleep and fatigue in Maritime pilots
Tait, J. L., Chambers, T. P., Tait, R. S., & Main, L. C. (2021) · Ergonomics · doi:10.1080/00140139.2021.1882705 · Cited by 16
Perianesthesia Nursing Advocacy: An Influential Voice for Patient Safety
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Scali, E. P., Strovski, E., Forster, B. B., Mar, C., & Chang, S. D. (2015) · Canadian Association of Radiologists Journal · doi:10.1016/j.carj.2014.07.003 · Cited by 14
Les chirurgiens peuvent apprendre des pilotes : place du facteur humain en chirurgie
Sockeel, P., Chatelain, E., Massoure, M.-P., David, P., Chapellier, X., & Buffat, S. (2009) · Journal de Chirurgie · doi:10.1016/j.jchir.2009.06.011 · Cited by 14
Surgery is different: A response to the IOM report
Fischer, J. E., Healy, G. B., & Britt, L. D. (2009) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2009.01.001 · Cited by 14
Determining Resident Sleep During and After Call With Commercial Sleep Monitoring Devices
Morhardt, D. R., Luckenbaugh, A. N., Goldstein, C. A., & Faerber, G. J. (2017) · Urology · doi:10.1016/j.urology.2017.03.059 · Cited by 14
Sleep deprivation in interventional cardiology: Implications for patient care and physician‐health
Sandoval, Y. B., Lobo, A. S., Somers, V. K., Rosenfield, K., Bradley, S. M., Sorajja, P., Tajti, P., & Brilakis, E. S. (2017) · Catheterization and Cardiovascular Interventions · doi:10.1002/ccd.27185 · Cited by 14
“Attentional failures occurred at more than double the rate during the night on the traditional schedule (extend work shifts, 24 hr or more) as compared with the intervention schedule (<16 hr) [16].”
BackgroundFeasibility and acceptability of a workers’ health surveillance program for hospital physicians
Ruitenburg, M. M., Plat, M.-C. J., Frings‐Dresen, M. H. W., & Sluiter, J. K. (2015) · International Journal of Occupational Medicine and Environmental Health · doi:10.13075/ijomeh.1896.00420 · Cited by 15
Condren, A. B., & Divino, C. M. (2015) · Journal of surgical education · doi:10.1016/j.jsurg.2015.04.018 · Cited by 14
Advances in neurological education: A time to share
Galetta, S. L., Józefowicz, R. F., & Avitzur, O. (2006) · Annals of Neurology · doi:10.1002/ana.20835 · Cited by 14
Shift Work, Severe Sleepiness and Safety
Åkerstedt, T., & Kecklund, G. (2011) · Industrial Health · doi:10.2486/indhealth.ms4902ed · Cited by 13
Lin, S., Lin, C., Hsu, W., Wang, I., Chang, C.-C., Huang, C., Kao, C., Liu, S., & Sung, F. (2013) · Journal of Occupational Health · doi:10.1539/joh.12-0263-oa · Cited by 13
Gunsilius, C. Z., Price, M. M., Rogers, S. L., Flynn, E., & Jha, A. P. (2024) · BMC Medical Education · doi:10.1186/s12909-024-05119-5 · Cited by 17
“Attentional lapses are known to correspond with psychological health challenges, [26] and increase medical errors in medical trainees [27].”
BackgroundDay Float: An Alternative to the Night Float Coverage System for Residency Programs
Suryadevara, A. C., Zandifar, H., Guyer, M., & Kellman, R. M. (2008) · The Laryngoscope · doi:10.1097/mlg.0b013e31816bf52f · Cited by 13
The ACGME’s 2011 Changes to Resident Duty Hours: Are They an Unfunded Mandate on Teaching Hospitals?
Romano, P. S., & Volpp, K. G. M. (2011) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1936-x · Cited by 13
Sleep, health, and society: the contribution of epidemiology
Cappuccio, F. P., Miller, M. A., & Lockley, S. W. (2010) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199566594.003.0001 · Cited by 14
Self-citationde Muga, M. V., Serrano‐Llop, A., Escudero, E. R., et al. (2015) · Anales de Pediatría · doi:10.1016/j.anpedi.2014.11.014 · Cited by 13
Sleep- and Wake-Promoting Drugs: Where Are They Being Sourced, and What Is Their Impact?
Ogeil, R. P., Phillips, J. G., Savic, M., & Lubman, D. I. (2019) · Substance Use & Misuse · doi:10.1080/10826084.2019.1609040 · Cited by 15
“There is increasing recognition of poorer health and safety outcomes in groups that act in opposition to this circadian drive (Harrington, 2001; Lockley et al., 2004; Rajaratnam et al., 2011; Barger et al., 2015).”
BackgroundThe radiology impact of healthcare errors during shift work
Elliott, J., & Williamson, K. (2019) · Radiography · doi:10.1016/j.radi.2019.12.007 · Cited by 13
“SWD is caused by disruption of the body’s natural circadian rhythm; a 24-hour cycle of changes in body function according to being awake or asleep.”
InfluentialImpact of the ACGME Work Hour Requirements
Watson, J. C. (2005) · Neurology · doi:10.1212/01.wnl.0000152728.17155.41 · Cited by 13
Attending Work Hour Restrictions
Hyman, N. (2009) · Archives of Surgery · doi:10.1001/archsurg.2008.518 · Cited by 13
Kuvin, J. T. (2008) · Circulation · doi:10.1161/circulationaha.107.756965 · Cited by 13
Merry, A., & Warman, G. R. (2006) · Anaesthesia and Intensive Care · doi:10.1177/0310057x0603400522 · Cited by 13
Austria‐Corrales, F., Valdes, B., Kienhelger, L. H., et al. (2011) · Universitas Psychologica · doi:10.11144/javeriana.upsy11-1.reea · Cited by 12
“…al que pertenecían los sujetos, los años de antigüedad, el número de horas promedio que trabajaron por semana cada uno de los trabajadores, entre otras, que han demostrado tener efectos significativos en el incremento de síntomas de síndrome de burnout (Iglehart, 2009; Lockley et al., 2004).”
BackgroundSchimmack, S. J., Hinz, U., Wagner, A., Schmidt, T., Strothmann, H., Büchler, M. W., & Schmitz‐Winnenthal, H. (2014) · Health Economics Review · doi:10.1186/s13561-014-0014-6 · Cited by 12
Should Sleep-Deprived Surgeons Be Prohibited From Operating Without Patients' Consent?
Czeisler, C. A., Pellegrini, C. A., & Sade, R. M. (2013) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2012.11.052 · Cited by 12
“Young physicians in training who were randomized to work extended duration (>24 hour) shifts experienced twice as many attentional failures[30] and on average made 36 percent more serious errors caring for patients in intensive care units, including 55 percent more serious medical errors that reached the patient and 4…”
Self-citationAdverse Medical Events in the NICU
Morriss, F. H. (2007) · NeoReviews · doi:10.1542/neo.9-1-e8 · Cited by 12
“Lockley and associates ( 39 ) studied 20 internal medicine residents during two randomly assigned 3-week rotations in adult intensive care units, one of which was prior to the change in work hours and schedule and the other of which was after changes were made.”
BackgroundHuizinga, C. R. H., Tummers, F. H. M. P., de Mheen, P. J. M., Cohen, A. F., & van der Bogt, K. E. A. (2019) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2019.04.007 · Cited by 11
Postgraduate medical education: residents rating the quality of their training.
Saaiq, M., & Khaleeq-uz-Zaman (2013) · PubMed · Cited by 12
Neurology Education: Current and Emerging Concepts in Residency and Fellowship Training
Stern, B. J., Józefowicz, R. F., Kissela, B. M., et al. (2010) · Neurologic Clinics · doi:10.1016/j.ncl.2009.11.011 · Cited by 12
Nuthalapaty, F. S., Carver, A. R., Nuthalapaty, E. S., & Ramsey, P. S. (2006) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2005.10.215 · Cited by 12
Achieving balance in a surgical life: A personal perspective on a Sisyphean task
Orrom, W. J. (2008) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2007.12.030 · Cited by 12
Farquhar, M. (2016) · Archives of Disease in Childhood Education & Practice · doi:10.1136/archdischild-2016-312119 · Cited by 12
Fatigue, Countermeasures, and Performance Enhancement in Resident Physicians
Rose, S. H., & Curry, T. B. (2009) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(11)60665-4 · Cited by 16
Perceived Impact of Duty Hours Regulations: A Survey of Residents and Program Directors
West, C. P., Cook, R. J., Popkave, C., & Kolars, J. C. (2007) · The American Journal of Medicine · doi:10.1016/j.amjmed.2007.03.017 · Cited by 12
Working the night shift : preparation, survival and recovery
Horrocks, N. P. C., & Pounder, R. E. (2006) · University of Salford Institutional Repository (University of Salford) · Cited by 12
Environmental Safety Including Chemical Dependency
Nicholau, D., & Arnold, W. P. (2010) · Elsevier eBooks · doi:10.1016/b978-0-443-06959-8.00101-1 · Cited by 10
New Zealanders working non-standard hours also have greater exposure to other workplace hazards
Jay, S. M., Gander, P. H., Eng, A., Cheng, S., Douwes, J. E., Ellison‐Loschmann, L., McLean, D., Pearce, N. E., & Mannetje, A. ’. (2017) · Chronobiology International · doi:10.1080/07420528.2017.1307850 · Cited by 16
“©2017 Taylor & Francis Group, LLC increased risk of errors and accidents (e.g. Folkard & Tucker, 2003; Gale et al., 2007; Lockley et al., 2004).”
BackgroundWang, H.-H., & Lin, Y. (2021) · Journal of Medical Internet Research · doi:10.2196/26763 · Cited by 12
“Our result that app-recorded work hours strongly correlated with their self-reported counterparts ( r =0.86-0.88, P .001) was consistent with previous studies [2,14].”
BackgroundResultInfluentialFatigue, Countermeasures, and Performance Enhancement in Resident Physicians
Rose, S. H., & Curry, T. B. (2009) · Mayo Clinic Proceedings · doi:10.4065/84.11.955 · Cited by 11
Filippidis, F. T., Mian, S. S., & Millett, C. J. (2016) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzw097 · Cited by 11
Working hours of obstetrics and gynaecology trainees in Australia and New Zealand
Acton, J. N., Tucker, P. E., Bulsara, M. K., & Cohen, P. A. (2017) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/ajo.12605 · Cited by 12
Sleep and Work in ICU Physicians During a Randomized Trial of Nighttime Intensivist Staffing*
Bakhru, R. N., Basner, M., Kerlin, M. P., Halpern, S. D., Hansen-Flaschen, J. H., Rosen, I. M., Dinges, D. F., & Schweickert, W. D. (2019) · Critical Care Medicine · doi:10.1097/ccm.0000000000003773 · Cited by 11
Shifting perceptions: a pre-post study to assess the impact of a senior resident rotation bundle
Fabreau, G. E., Elliott, M. J., Khanna, S. K., Minty, E. P., Wallace, J. E., de Grood, J., Lewin, A. M., Brown, G. E., Bharwani, A. M., Gilmour, J. G., et al. (2013) · BMC Medical Education · doi:10.1186/1472-6920-13-115 · Cited by 11
“Background Extended duty hours for resident physicians have been associated with negative consequences such as decreased working memory, worsening cognitive performance and increased technical error [1-8], poor performance on learning measures, patient safety concerns, increased workplace injury, burnout, and personal…”
BackgroundAchieving Balance on the Inpatient Internal Medicine Wards
Cohee, B. M., Hartzell, J. D., & Shimeall, W. T. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000213 · Cited by 11
Hippocrates Affirmed? Limiting Residents' Work Hours Does No Harm to Patients
Goldman, L., & Fiebach, N. H. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-2-200707170-00165 · Cited by 11
Metadata
- Authors
- Lockley, S. W., Cronin, J. W., Evans, E. E., Cade, B. E., Lee, C. J., Landrigan, C. P., Rothschild, J. M., Katz, J. T., Lilly, C. M., Stone, P. H., Aeschbach, D., & Czeisler, C. A.
- Affiliations
- Brigham and Women's Hospital (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2004-10-28
- Volume
- 351
- Issue
- 18
- Pages
- 1829-1837
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2166406376
- Cited by
- 913
- References
- 41
- Citations by year
- 2026: 20 · 2025: 32 · 2024: 24 · 2023: 24 · 2022: 26 · 2021: 31 · 2020: 19 · 2019: 46 · 2018: 36 · 2017: 33 · 2016: 37 · 2015: 41 · 2014: 57 · 2013: 49 · 2012: 54
- FWCI
- 87.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
- Funders
- National Aeronautics and Space Administration (NCC958)
- Brigham and Women's Hospital (M01 RR02635, T32 HL079010)
- National Space Biomedical Research Institute (NCC 9‐58)
- Wellcome Trust
- Agency for Healthcare Research and Quality (F32 HS14130, K08 HS13333, R01 HS 12032, RO1 HS12032)
- National Heart, Lung, and Blood Institute (T32 HL079010)
- National Center for Research Resources (M01RR002635)
- National Institute for Occupational Safety and Health (R01 OH07567)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Nursing › Leadership and Management › Hospital Admissions and Outcomes
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- sleep duration, attentional failures, graduate medical education, intensive care unit, sleep deprivation, resident fatigue
- MeSH terms
- Adult, Attention, Female, Humans, Intensive Care Units, Internal Medicine, Internship and Residency, Male, Personnel Staffing and Scheduling, Sleep, Sleep Deprivation, Work Schedule Tolerance, Workload, Polysomnography
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