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Related Experiment Video

Updated: Jun 16, 2026

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments

Published on: August 8, 2019

Resident productivity: trends over consecutive shifts.

Rebecca Jeanmonod¹, Sara Damewood, Christopher Brook

¹Department of Emergency Medicine, St. Luke's Hospital, Bethlehem, PA 18015, USA. rebeccajeanmonod@yahoo.com

International Journal of Emergency Medicine

|February 17, 2010

Summary

Resident physicians maintain or improve patient evaluation productivity over consecutive shifts, contrary to assumptions of fatigue. This finding is crucial for optimizing emergency medicine staffing and resident education.

Keywords:

Administration Overcrowding Resident education

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Area of Science:

Medical Education
Emergency Medicine
Healthcare Operations

Background:

Resident physician performance, including patient volume and acuity, generally improves with training level.
Previous research has not investigated whether resident productivity declines during consecutive shifts.

Purpose of the Study:

To determine the relationship between resident productivity and the number of consecutive shifts worked.
To identify peak resident productivity to optimize staffing and patient flow.
To enhance resident exposure to patients for educational benefit.

Main Methods:

A retrospective review of emergency medicine (EM) resident productivity, defined as patients evaluated per hour per shift.
Data collected via patient tracker software and verified against computerized medical records.
Analysis of variance (ANOVA) used to compare productivity across consecutive shifts (shift 1, 2, 3, etc.).

Main Results:

First-year residents showed non-significant productivity changes (0.82, 0.81, 0.91 patients/hour).
Second-year residents demonstrated a significant increase in productivity over consecutive shifts (1.12, 1.08, 1.17, 1.28 patients/hour; p=0.006).
Third-year residents also showed a significant improvement in productivity across consecutive shifts (1.19, 1.24, 1.33 patients/hour; p=0.02).

Conclusions:

Resident physicians do not experience decreased productivity during consecutive shifts.
Productivity is maintained or enhanced over multiple consecutive shifts.
Findings suggest current staffing models may not account for sustained or improving resident performance.