Abstract
Purpose: :
To measure the effect of acute sleep deprivation on anterior segment surgery skills by using a surgical simulator.
Methods: :
Nine ophthalmology residents (3 per training year) were prospectively evaluated by using the EYESi surgical simulator on 3 occasions: pre-call (≥7 hours sleep in previous 24 hours), post-work (8 hour work day, ≥7 hours sleep in previous 24 hours), and post-call (< 3 hours sleep in previous 24 hours). Participants kept logs to record sleep hours. The degree of sleepiness was assessed by using the Epworth Sleepiness Scale (ESS). Caffeine consumption was restricted 12 hours prior to testing. Technical skill was assessed by using the EYESi anti-tremor and forceps training modules and recorded on a 100-point performance scale. Performance data was compared by using a 3-factor repeated measures analysis of variance.
Results: :
Mean hours of sleep was less in post-call residents (1.9 ± 1.2 hours) when compared to pre-call (7.6 ± 0.6 hours, P<0.001) and post work (7.0 ± 0.4 hours, P<0.001). Similarly, degree of sleepiness (mean ESS) was increased in post-call residents (14.7 ± 4.4) when compared to pre-call (2.7 ± 1.2, P<0.001) and post work (4.9 ± 3.2, P<0.001). No difference in technical performance was detected by using the anti-tremor module in pre-call (85 ± 20 points), post-work (80 ± 24 points), and post-call (81 ± 26 points; P=0.51) residents or by using the forceps module in pre-call (99 ± 1 points), post-work (98 ± 4 points), and post-call (98 ± 5 points; P=0.11) residents.
Conclusions: :
Call-associated sleep deprivation was not associated with increased technical errors in the performance of simulated anterior segment surgical skills.
Keywords: training/teaching cataract surgery • cataract • learning