Capsule Commentary on Zebrowski et al., So Tired: Predictive Utility of Baseline Sleep Screening in a Longitudinal Observational Survey Cohort of First-Year Residents

Capsule Commentary on Zebrowski et al., So Tired: Predictive Utility of Baseline Sleep Screening... JGIM CAPSULE COMMENTARIES Capsule Commentary on Zebrowski et al., So Tired: Predictive Utility of Baseline Sleep Screening in a Longitudinal Observational Survey Cohort of First-Year Residents Lisa C. Martinez, MD FACP Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA. J Gen Intern Med 33(6):942 serious medical error. In another study, the ESS did not show DOI: 10.1007/s11606-018-4369-y any statistically significant effect on patient outcomes. As we © Society of General Internal Medicine 2018 focus on ways to assess contributors to intern and resident performance, it is important to assess whether these markers have real and measurable effects on either patient or resident outcomes. For educators, this study promotes consideration of sleep his study exploring incoming interns’ sleep dysfunction dysfunction in interns as they progress through their first year; and how it is impacted by intern year comes at a time however, it does not address the real world implications of this when there is considerable focus on outcomes in residency dysfunction. Continued research into the specific markers that education, specifically, resident wellness and patient safety. play a role in resident performance and outcomes needs to be The investigators had previously reported sleep dysfunction in continued. incoming interns and with this study investigated whether these baseline characteristics evolve during internship. Fifty- four percent of the 281 residents enrolled at study initiation Corresponding Author: Lisa C. Martinez, MD FACP; Schmidt College completed the year-long follow-up. The incoming residents of Medicine Florida Atlantic University, Boca Raton, FL, USA (e-mail: lmartinez@health.fau.edu). completed the Pittsburg Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS), along with demographic Compliance with ethical standards: information. This study was performed when interns’ schedule was working under the 2011 work-hour restrictions. While the Conflict of interest: Theauthordeclaresthat he/shedoesnot have a ACGME has expanded the duty hours to now include 24 h conflict of interest. shifts, many programs have not incorporated this schedule, so this may still be valid for many programs throughout the country. REFERENCES The results of this investigation showed that interns gener- 1. Zebrowski JP, Pulliam SJ, Denninger JW, Berkowitz LR.So Tired: ally have worsening scores in their ESS and PSQI, specifically Predictive Utility of Baseline Sleep Screening in a Longitudinal Observa- tional Survey Cohort of First-Year Residents. J Gen Intern Med. https:// in daytime dysfunction, sleep disturbance, and change in doi.org/10.1007/s11606-018-4348-3. bedtime and wake time leading to decreased sleep duration, 2. Pulliam SJ, Weinstein DF, Malhotra A, Macklin EA, Berkowitz LR. Baseline sleep dysfunction among matriculating interns. J Grad Med Educ. regardless of their specialty. This offers insight into the possi- 2012; 4(2):202–8. ble effect internship has on sleep quality. This study, however, 3. Sen S, Kranzler HR, Didwania AK, et al. Effects of the 2011 Duty Hour did not address the effect that sleep dysfunction has on patient Reforms on Interns and Their Patients: A Prospective longitudinal Cohort Study. JAMA Intern Med. 2013;173(8):658–662. outcomes or resident wellness. Previous studies have looked at 4. West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD. Association the effect of the 2011 duty-hour restrictions on medical errors of resident fatigue and distress with perceived medical errors. JAMA. 2009;302(12):1294–300. and depressive symptoms, showing that despite no effect on sleep duration, residents still reported concern of making a Published online February 27, 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of General Internal Medicine Springer Journals

Capsule Commentary on Zebrowski et al., So Tired: Predictive Utility of Baseline Sleep Screening in a Longitudinal Observational Survey Cohort of First-Year Residents

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Publisher
Springer US
Copyright
Copyright © 2018 by Society of General Internal Medicine
Subject
Medicine & Public Health; Internal Medicine
ISSN
0884-8734
eISSN
1525-1497
D.O.I.
10.1007/s11606-018-4369-y
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Abstract

JGIM CAPSULE COMMENTARIES Capsule Commentary on Zebrowski et al., So Tired: Predictive Utility of Baseline Sleep Screening in a Longitudinal Observational Survey Cohort of First-Year Residents Lisa C. Martinez, MD FACP Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA. J Gen Intern Med 33(6):942 serious medical error. In another study, the ESS did not show DOI: 10.1007/s11606-018-4369-y any statistically significant effect on patient outcomes. As we © Society of General Internal Medicine 2018 focus on ways to assess contributors to intern and resident performance, it is important to assess whether these markers have real and measurable effects on either patient or resident outcomes. For educators, this study promotes consideration of sleep his study exploring incoming interns’ sleep dysfunction dysfunction in interns as they progress through their first year; and how it is impacted by intern year comes at a time however, it does not address the real world implications of this when there is considerable focus on outcomes in residency dysfunction. Continued research into the specific markers that education, specifically, resident wellness and patient safety. play a role in resident performance and outcomes needs to be The investigators had previously reported sleep dysfunction in continued. incoming interns and with this study investigated whether these baseline characteristics evolve during internship. Fifty- four percent of the 281 residents enrolled at study initiation Corresponding Author: Lisa C. Martinez, MD FACP; Schmidt College completed the year-long follow-up. The incoming residents of Medicine Florida Atlantic University, Boca Raton, FL, USA (e-mail: lmartinez@health.fau.edu). completed the Pittsburg Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS), along with demographic Compliance with ethical standards: information. This study was performed when interns’ schedule was working under the 2011 work-hour restrictions. While the Conflict of interest: Theauthordeclaresthat he/shedoesnot have a ACGME has expanded the duty hours to now include 24 h conflict of interest. shifts, many programs have not incorporated this schedule, so this may still be valid for many programs throughout the country. REFERENCES The results of this investigation showed that interns gener- 1. Zebrowski JP, Pulliam SJ, Denninger JW, Berkowitz LR.So Tired: ally have worsening scores in their ESS and PSQI, specifically Predictive Utility of Baseline Sleep Screening in a Longitudinal Observa- tional Survey Cohort of First-Year Residents. J Gen Intern Med. https:// in daytime dysfunction, sleep disturbance, and change in doi.org/10.1007/s11606-018-4348-3. bedtime and wake time leading to decreased sleep duration, 2. Pulliam SJ, Weinstein DF, Malhotra A, Macklin EA, Berkowitz LR. Baseline sleep dysfunction among matriculating interns. J Grad Med Educ. regardless of their specialty. This offers insight into the possi- 2012; 4(2):202–8. ble effect internship has on sleep quality. This study, however, 3. Sen S, Kranzler HR, Didwania AK, et al. Effects of the 2011 Duty Hour did not address the effect that sleep dysfunction has on patient Reforms on Interns and Their Patients: A Prospective longitudinal Cohort Study. JAMA Intern Med. 2013;173(8):658–662. outcomes or resident wellness. Previous studies have looked at 4. West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD. Association the effect of the 2011 duty-hour restrictions on medical errors of resident fatigue and distress with perceived medical errors. JAMA. 2009;302(12):1294–300. and depressive symptoms, showing that despite no effect on sleep duration, residents still reported concern of making a Published online February 27, 2018

Journal

Journal of General Internal MedicineSpringer Journals

Published: Feb 27, 2018

References

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