Table 1.
Studies of resident quality of life, sleep, and fatigue
| Source | Study Design | Population and Setting | Intervention Type | Study Outcomes | Study Quality |
|---|---|---|---|---|---|
| Carey29 | Retrospective, “before and after” controlled trial | Ob/Gyn residents at a single hospital | Reduction in extended shifts from Q3 to at most Q7, with most shifts <13 h | Decrease in resident rating of sleep deprivation. | Level II-3 |
| Goldstein26 | Prospective, “before and after” controlled trial | Surgical residents at a single hospital | Transition from Q4 call to a night float system with 12- to 14-h shifts | Improvement in overall fatigue, hours of sleep, and availability for family events with night float system. | Level II-3 |
| Gottlieb23 | Prospective, concurrent controlled trial | Internal medicine residents at a single VA medical center | Comparison of a Q4 call schedule to night float system with maximum 16-h shifts | No difference for anxiety or hostility scores, but lower depression scores for residents on the night float system. | Level II-1 |
| Hutter25 | Prospective, “before and after” controlled trial | Surgical residents at a single hospital | Reduction in call frequency from Q3 to Q4 | Decrease in emotional exhaustion and increase in motivation to work on Q4 schedule. | Level II-3 |
| Lockley20 | Prospective, randomized controlled trial | Internal medicine interns working in the MICU/CCU at a single hospital | Comparison of traditional Q3 system with 30-h shifts to a system with maximum 16-h shifts | Increased sleep and decreased attentional failures with the 16-h maximum compared to the 30-h maximum | Level I |
| Lund28 | Prospective, “before and after” controlled trial | Ob/Gyn residents at a single hospital | 25% overall reduction in call frequency for all residents | Improvement in resident satisfaction with program but no change in other quality of life measures. | Level II-3 |
| Nichols27 | Retrospective, “before and after” controlled trial | Ob/Gyn residents at a single hospital | Unspecified reduction in call frequency for PGY2 residents with implementation of night resident system | Residents with reduced call frequency more supportive of co-resident becoming pregnant; no change in overall stress level. | Level II-3 |
| Sawyer24 | Prospective, concurrent controlled trial | Surgical interns at a single hospital | Comparison of interns on Q2, Q3, and Q4 schedules | Increased overall satisfaction and sleep, decreased fatigue on the Q4 call schedule. | Level II-1 |