The effect of call on neurosurgery residents' skills: Implications for policy regarding resident call periods - Clinical article

Aruna Ganju, Kanav Kahol, Peter Lee, Narina Simonian, Steven J. Quinn, John J. Ferrara, H. Hunt Batjer

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Object. Although fatigue and its effects on surgical proficiency have been an actively researched area, previous studies have not examined the effect of fatigue on neurosurgery residents specifically. This study aims to quantify the effect of fatigue on the psychomotor and cognitive skills of neurosurgery residents. Methods. Seven neurosurgery residents performed a minimum of 3 and a maximum of 4 sessions of 6 surgical exercises precall and postcall. The simulation exercises were designed to measure a surgeon's cognitive abilities, such as memory and attention, while performing simulated surgical tasks and exercises that have been previously validated in several studies, including studies measuring the impact of fatigue on general surgery residents. Each exercise measured tool-movement smoothness, time elapsed, and cognitive errors. The change in surgical skills in precall and postcall conditions was assessed by means of an ANOVA, with p &λτ; 0.05 considered statistically significant. Results. The neurosurgery residents did not show a statistically significant difference in their surgical skills between the pre- and postcall states (p &λτ; 0.3, p &λτ; 0.4, and p &λτ; 0.2 for movement smoothness, time elapsed, and cognitive errors, respectively). The mean decrement for all residents in the postcall condition was 13.1%. Conclusions. Postcall fatigue is associated with a marginal decrease in proficiency during simulated surgery in neurosurgery residents. In a similar study, general surgery residents showed a statistically significant decrement of 27.3% in the postcall condition. The impact of fatigue on different specialties should be further investigated prior to implementation of a national physician work-hour policy.

Original languageEnglish (US)
Pages (from-to)478-482
Number of pages5
JournalJournal of neurosurgery
Issue number3
StatePublished - Mar 2012


  • Accreditation Council for Graduate Medical Education
  • Neurosurgery resident
  • Work-hour restriction

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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