Abstract
Purpose :
Lack of sleep and activity are commonly associated with resident burnout. Proposed strategies to address resident burnout include restructuring traditional call schedules to provide time for sleep recovery post call. This study examines the effects of implementing night-float and post-call relief on sleep, activity, and burnout in post-graduate year (PGY)-2 ophthalmology residents at the University of Washington (UW) between 2017-2021 using wrist actigraphy and standardized burnout surveys.
Methods :
Data from 20 PGY-2 ophthalmology residents at UW were collected with Fitbit Alta HR wrist actigraphers between 2017-2020. Three residents were excluded due to insufficient sleep or activity data. From 2017-2019, residents took home call every 5 nights and returned to full clinical duties on their post-call workday. From 2019-2021, a night-float resident without daytime clinical duties took call for 3 nights a week while remaining residents rotated call duties for the remaining 4 nights of the week with no clinical duties assigned past noon on their post-call day. Burnout was evaluated by Maslach Burnout Inventory surveys and Depression Anxiety Stress scales. T-tests were used to compare average sleep, activity, and sedentary time between residents before and after implementing night-float and post-call relief. Pearson correlation was used to associate sleep and activity metrics with averaged median burnout scores.
Results :
PGY-2 residents with night-float and post-call relief (N=8) had greater average daily activity (17.1±10 min vs 5.60±3.5 min, p=0.02) and lower average sedentary time (14.1±2.5 hours vs 17.5±2.7 hours, p=0.02) compared to residents without night-float and post-call relief (N=9). No statistically significant differences in sleep or burnout were found in the two cohorts, though residents with night-float and post-call relief trended toward lower emotional exhaustion (p=0.10) and stress (p=0.10). For all PGY-2 residents, there was a negative correlation between activity and stress, and a positive correlation between sedentary time and emotional exhaustion, anxiety, and stress.
Conclusions :
Night-float and post-call relief led to greater average physical activity and lower average sedentary time in PGY-2 ophthalmology residents. Increased physical activity and decreased sedentary time correlates to decreased emotional exhaustion, anxiety, and stress.
This is a 2021 ARVO Annual Meeting abstract.