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Master Thesis

The deleterious impact of 24 hours shifts on medical reasoning is associated to their frequency among anesthesiology and critical care residents and physicians: a randomized crossover study

Abstract : Background: Shift is common for anesthesia and critical care doctors, but its impact on medical reasoning remains uncertain. Objective: The present study attempted to evaluate the impact of shift on the clinical reasoning performance of anesthesiology and intensive care doctors (residents and seniors). Changes in medical reasoning were measured by script concordance tests (SCT). Methods: This multicentric, prospective, randomized, cross-over study was conducted in 5 public hospitals of Normandy region. Two groups of anesthesia and critical care doctors were formed, and each was assessed using SCT. Performance was assessed using a 69-items SCT. Group A completed the first part of the assessment (38 SCT) after a weekend without work and the second part (31 SCT) after a 24-hours shift. Group B did the same in reverse order. The primary outcome was medical reasoning’s performance as measured by SCT after a weekend without work and after a 24-hours shift. Results: In this study, 84 doctors (26 physicians and 58 residents) were randomized. Performance was lower after 24-hours shift than after a rest period (68 [SD 8] vs 64 [SD 9], p = 0.0082). Conclusion: Our study suggests that medical reasoning’ performance of anesthesiologists, measured by the SCT, was significantly poorer after 24h-shift than after rest period. This observation confirms the hypothesis that many shifts should be avoided to prevent the occurrence of medical errors. The impact of shift and the fatigue it generates should be studied further.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03403810
Contributor : Claire Leboeuf Connect in order to contact the contributor
Submitted on : Tuesday, October 26, 2021 - 12:24:40 PM
Last modification on : Sunday, November 14, 2021 - 3:38:57 AM

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  • HAL Id : dumas-03403810, version 1

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Mathilde Ramier. The deleterious impact of 24 hours shifts on medical reasoning is associated to their frequency among anesthesiology and critical care residents and physicians: a randomized crossover study. Human health and pathology. 2021. ⟨dumas-03403810⟩

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