RT Journal Article
SR Electronic
T1 Effects of sleepiness on clinical decision making among paramedic students: a simulated night shift study
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 45
OP 51
DO 10.1136/emermed-2019-209211
VO 39
IS 1
A1 Bartlett, Danielle
A1 Hansen, Sara
A1 Cruickshank, Travis
A1 Rankin, Timothy
A1 Zaenker, Pauline
A1 Mazzucchelli, Gavin
A1 Gaston, Matthew
A1 Du Plooy, Dirk
A1 Minhaj, Zahed
A1 Errey, William
A1 Rumble, Tyron
A1 Hay, Taylor
A1 Miles, Alecka
A1 Mills, Brennen
YR 2022
UL http://emj.bmj.com/content/39/1/45.abstract
AB Objective Paramedics are at the forefront of emergency healthcare. Quick and careful decision making is required to effectively care for their patients; however, excessive sleepiness has the potential to impact on clinical decision making. Studies investigating the effects of night shift work on sleepiness, cognitive function and clinical performance in the prehospital setting are limited. Here, we aimed to determine the extent to which sleepiness is experienced over the course of a simulation-based 13-hour night shift and how this impacts on clinical performance and reaction time.Methods Twenty-four second year paramedic students undertook a 13-hour night shift simulation study in August 2017. The study consisted of 10 real-to-life clinical scenarios. Sleepiness, perceived workload and motivation were self-reported, and clinical performance graded for each scenario. Reaction time, visual attention and task switching were also evaluated following each block of two scenarios.Results The accuracy of participants’ clinical decision making declined significantly over the 13-hour night shift simulation. This was accompanied by an increase in sleepiness and a steady decline in motivation. Participants performed significantly better on the cognitive flexibility task across the duration of the simulated night shift and no changes were observed on the reaction time task. Perceived workload varied across the course of the night.Conclusion Overall, increased sleepiness and decreased clinical decision making were noted towards the end of the 13-hour simulated night shift. It is unclear the extent to which these results are reflective of practising paramedics who have endured several years of night shift work, however, this could have serious implications for patient outcomes and warrants further investigation.Deidentified data will be made available on reasonable request to the corresponding author.