Laparoscopic skills and cognitive function are not affected in surgeons during a night shift

J Surg Educ. Jul-Aug 2014;71(4):543-50. doi: 10.1016/j.jsurg.2013.12.007. Epub 2014 May 10.


Objective: To monitor surgeons' performance and cognition during night shifts.

Design: Surgeons were monitored before call and on call (17-hour shift). Psychomotor performance was assessed by laparoscopic simulation and cognition by the d2 test of attention. The surgeons performed the laparoscopic simulation and the d2 test of attention at 8 a.m. before call and at 4 a.m. on call. Sleep was measured by wrist actigraphy and sleepiness by the Karolinska sleepiness scale.

Setting: Department of Surgery at Herlev Hospital, Denmark.

Participants: Overall, 30 interns, residents, and attending surgeons were included and completed the study. One participant was subsequently excluded owing to myxedema.

Results: The surgeons slept significantly less on call than before call. There was increasing sleepiness on call; however, no significant differences were found in the precall laparoscopic simulation values compared with on-call values. The d2 test of attention showed significantly improved values on call compared with before call.

Conclusion: Sleep deprivation during a 17-hour night shift did not impair surgeons' psychomotor or cognitive performance.

Keywords: Patient Care; Practice-Based Learning and Improvement; Systems-Based Practice; actigraphy; d2 test of attention; laparoscopic simulation; night shifts; sleep deprivation; surgeons.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actigraphy
  • Adult
  • Attention
  • Clinical Competence*
  • Cognition / physiology
  • Female
  • General Surgery*
  • Humans
  • Internship and Residency
  • Laparoscopy*
  • Male
  • Psychomotor Performance*
  • Sleep Deprivation / physiopathology
  • Sleep Disorders, Circadian Rhythm / epidemiology*
  • Sleep Disorders, Circadian Rhythm / physiopathology