Physicians Performance After Night Shifts

Condition(s) studied

Investigational drug(s) / intervention(s)

Simulation: Each simulation will focus on a trauma case deemed to be complex, that is to say one involving difficult decision-making. Each simulation session lasts approximately thirty minutes. It includes a time to complete the questionnaires necessary for carrying out the study, before and / or after the simulated practice depending on the type of questionnaire, a brief briefing on the simulation scenario, and the time for the simulated practice.

Study summary

Emergency medicine is one of the professional activities integrating a night activity into working time. Concerns about the sleep deprivation that this activity generates have been growing for the past thirty years. However, at present, the pace - duration and repetition - of this activity does not yet seem to be optimized, and therefore continues to be the subject of questions in terms of safety of care and quality of life at work. One of the peculiarities of emergency medicine is that doctors have to work in a crisis situation. A situation is qualified as critical for a patient when his state of health is unstable, and with an evolution which can be rapidly pejorative. Crisis situations are at the heart of the emergency room profession, and due to their potential seriousness for the patients, it must be managed in all circumstances.

To cope with a crisis situation, a doctor needs to be efficient. However, performance calls for two types of skills: technical skills on one hand, and non-technical skills on the other.

This study therefore aims to answer the following question: are the non-technical skills of emergency physicians in the management of a crisis situation affected twenty-four hours after the end of a night shift? The study assesses the performance of emergency physicians via complex simulations at two time frames : 24h after a night shift (the post recovery performance simulation) and another time were the participant did not have night shifts in less than 3 nights (usual performance simulation).

Eligibility

Primary outcome measure(s)

• non-technical efficiency via the Ottawa GRS — 24 hours after a night shift
  Overall non-technical skill score assessed using the Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS). The Ottawa GRS scale assesses the following five criteria: * leadership skills * situational awareness * communication skills * problem solving * resource management For each of the criteria, a score between 1 and 7 is attributed. The scoring is made as follows: a score of 1 corresponds to a novice performance, a score of 3 corresponds to a performance of a novice with experience in Crisis Resource Management (CRM) and resuscitation, a score of 5 corresponds to the performance of a physician with sufficient experience in CRM and resuscitation to properly manage a crisis situation, finally a score of 7 corresponds to the performance of a physician expert in CRM and resuscitation. An average score of the five scores is taken to obtain an overall proficiency score, also out of 7, which will be used to compare Post Recovery Performance and Usual Performance
• non-technical efficiency via the Ottawa GRS — after a minimum of 3 nights free of night work
  Overall non-technical skill score assessed using the Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS). The Ottawa GRS scale assesses the following five criteria: * leadership skills * situational awareness * communication skills * problem solving * resource management For each of the criteria, a score between 1 and 7 is attributed. The scoring is made as follows: a score of 1 corresponds to a performance judged to be that of a novice, a score of 3 corresponds to a performance of a novice with experience in CRM and resuscitation, a score of 5 corresponds to the performance of a physician with sufficient experience in CRM and resuscitation to properly manage a crisis situation, finally a score of 7 corresponds to the performance of a physician expert in CRM and resuscitation. An average score of the five scores is taken to obtain an overall proficiency score, also out of 7, which will be used to compare Post Recovery Performance and Usual Performance

Trial sites (1)

More University Hospital, Toulouse trials in France