Lessons Learned to Aid in Developing Fatigue Risk Management Plans for Resident Physicians

Area of Science:

• Medical Education
• Occupational Health
• Physician Well-being

Background:

• Fatigue is a critical risk factor for resident physician performance decline, potentially leading to medical errors and reduced well-being.
• Sleep deprivation is a known contributor to fatigue, but it is only one factor in a complex phenomenon affecting residents.

Purpose of the Study:

• To explore resident physicians' experiences with fatigue.
• To identify strategies residents employ for managing fatigue.
• To inform the development of targeted fatigue risk management plans (FRMPs).

Main Methods:

• A single-site qualitative study involving interviews and focus groups with 57 resident physicians.
• Purposive sampling ensured representation across various programs, postgraduate levels, and genders.
• Thematic analysis using a quasi-constant comparison approach was employed to analyze transcribed data.

Main Results:

• A consensus emerged that fatigue negatively affects residents' physical, cognitive, and emotional states, impacting patient care and personal/professional productivity.
• Three primary themes for fatigue management strategies were identified: self-level, program-level, and system-level.
• These themes suggest a need for integrated strategies to effectively manage resident fatigue.

Conclusions:

• Resident fatigue is a multifaceted issue requiring management strategies beyond extended duty hours and sleep optimization.
• Effective FRMPs must incorporate complementary strategies at the individual resident, residency program, and healthcare system levels.
• Implementing comprehensive FRMPs can enhance resident well-being and improve patient care outcomes.