Relationship of neuroimaging to typical sleep times during a clinical reasoning task: a pilot study.

Background: Sleep deprivation and fatigue have been associated with medical errors, clinical performance decrements, and reduced quality of life for both practicing physicians and medical students. Greater understanding of the impact of sleep quantity on clinical reasoning could improve patient care...

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Publicado en:Military Medicine Vol. 180; pp. 129 - 136
Autores principales: Durning, Steven J, Kelly, William, Costanzo, Michelle E, Artino Jr, Anthony R, van der Vleuten, Cees, Beckman, Thomas J, Roy, Michael J, Holmboe, Eric S, Wittich, Christopher M, Schuwirth, Lambert, Artino, Anthony R Jr
Formato: Journal Article
Publicado: Oxford University Press / USA Apr2015 Supplement
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Oxford University Press / USA
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        10.7205/MILMED-D-14-00572
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        atl: Relationship of neuroimaging to typical sleep times during a clinical reasoning task: a pilot study.
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        au:
          Durning, Steven J
          Kelly, William
          Costanzo, Michelle E
          Artino Jr, Anthony R
          van der Vleuten, Cees
          Beckman, Thomas J
          Roy, Michael J
          Holmboe, Eric S
          Wittich, Christopher M
          Schuwirth, Lambert
          Artino, Anthony R Jr
        affil: Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda MD 20814
      sug:
        subj:
          Neuroradiography Methods
          Sleep Physiology
          Sleep Deprivation Psychosocial Factors
          Task Performance and Analysis
          Thinking
          Internal Medicine Education
          Fatigue Psychosocial Factors
          Clinical Competence
          Frontal Lobe Physiopathology
          Sleep Deprivation Physiopathology
          Internship and Residency
          Adult
          Time Factors
          Pilot Studies
          Magnetic Resonance Imaging Methods
          Actigraphy Methods
          Students, Medical Psychosocial Factors
          Faculty, Medical
          Clinical Assessment Tools
          Exercise of Self-Care Agency Scale
          Ferrans and Powers Quality of Life Index
          Impact of Events Scale
          Scales
          Ways of Coping Questionnaire
          Adult: 19-44 years
      ab: Background: Sleep deprivation and fatigue have been associated with medical errors, clinical performance decrements, and reduced quality of life for both practicing physicians and medical students. Greater understanding of the impact of sleep quantity on clinical reasoning could improve patient care. The purpose of our pilot study was to examine relationships between clinical reasoning (assessed by functional magnetic resonance imaging) and sleep time (measured in different ways by actigraphy) while answering multiple-choice questions (MCQs) from licensing agencies.Methods: Residents and faculty were administered a clinical reasoning exercise (MCQs from licensing bodies) during functional magnetic resonance imaging. Usual sleep patterns were sampled with actigraphy. Covariate analysis was used to examine the relationship between sleep duration (mean sleep, minimum sleep, maximum sleep) and brain activity during clinical reasoning (solving MCQs from licensing bodies).Results: The mean sleep time over the duration of monitoring for the group was 7.19 hours (SD 0.66) with a range of 6.1 to 8.1 hours (internal medicine faculty 7.1 hours, SD 0.41; internal medicine residents 7.27 hours, SD 0.92). There was a negative relationship between activation in the prefrontal cortex and minimum sleep time while reflecting on MCQs.Conclusion: Our findings provide evidence that the quantity of sleep can modulate brain activity while completing a clinically meaningful task that should be confirmed in larger studies. Our findings suggest that the construct of sleepiness may be more complex than appreciated by many and that the most important of these sleep measures in terms of outcomes remains to be determined.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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