Science-- there's something for everyone

Saturday, June 2, 2012

Surgeons really can work without sleep



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 entire experiment involved only 31 students, and only one lost night of sleep. Needless to say, being awake for more than 48 hours would almost surely have yielded different results. Still, I find it comforting to know that our medical professionals are functioning well even when spending the night at the hospital.

5 comments:

  1. 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.

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  2. There 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.

    I 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.

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    Replies
    1. Thank you for giving your perspective. That was very interesting.

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    2. Thank you for giving your perspective. That was very interesting.

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  3. Why did it post my reply twice? I must have REALLY found it interesting.

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