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Burnout and Cognitive Performance in the Emergency Department in Turkey: The Relationship with Resident Physicians'
Merve Akın Özdemir1, Emre Şancı2, İbrahim Ulaş Özturan3
1Kocaeli Derince Training and Research Hospital, Emergency Medicine Department, Health Science University, Kocaeli, Turkey.
Background:
Shift durations and working schedules are associated with cognitive fatigue and increased risk of burnout, potentially comprimising both physicians' well-being and patient safety.
Objectives:
This study aims to investigate the effects of different work schedules on cognitive performance and burnout levels among emergency medicine residents by psychological scales and objective cognitive testing.
Methods:
A total of 110 residents were enrolled from 4 institutions implementing 2 distinct work schedules: 24-hour shift system and 8-hour day + 16-hour night shift model. Cognitive performance was assessed using the Stroop test at multiple time points, and Interferance Index (IG) Scores were calculated to quantify the stroop effect. Burnout levels were evaluated with Maslach Burnout Inventory (MBI).
Results:
Residents working 24-hour shifts showed significant time-dependent decline in Stroop test performance and IG scores (p < 0.001), indicating reduced cognitive function by the end of the shift. Conversely, residents in the 8-hour day shifts also showed cognitive decline (p < 0.001), while no significant changes were observed in the 16-hour night shift group. Burnout analysis revealed that emotional exhaustion scores were significantly higher in the 8/16-hour group compared to the 24-hour group (p = 0.027), while depersonalization and personal accomplishment scores did not differ significantly between groups.
Conclusion:
Both long and fragmented shift models may impair cognitive performance among emergency medicine residents. Interestingly, the 8/16-hour system was associated with higher emotional exhaustion, despite its shorter duration. These findings underscore the importance of reevaluating shift structures to promote physician wellness and preserve clinical performance.
