Extended work hours contribute to fatigue among healthcare professionals, but their specific impact on anaesthesia providers remains poorly defined. This exploratory pilot study aimed to evaluate the sensitivity of a multidimensional assessment battery to quantify the impact of a 24-hour in-hospital call shift. The primary objective was to identify changes in complex clinical synthesis (represented by multitasking cost and non-technical decision-making). Secondary objectives included assessing changes in subjective state, standardised cognitive domains, and technical resuscitation performance. We conducted a prospective, observational, single-centre pilot study at a university hospital in Brussels, Belgium (January–March 2020). Sixteen anaesthesia providers (five junior residents, eight senior residents, three attending physicians) were assessed before and after a 24-hour in-hospital on-call shift. Outcomes included a battery of eight cognitive tests and a simulated Advanced Life Support scenario, evaluating both technical and non-technical skills. Subjective fatigue and sleepiness were measured with the Samn-Perelli Scale and the Karolinska Sleepiness Scale. Statistical analysis involved paired comparisons with Bonferroni corrections applied within outcome families. Participants reported significant increases in sleepiness (P = 0.006) and fatigue (P = 0.002) following the shift. Objective performance on standardised computerised tests was largely preserved. Sustained attention improved (P = 0.002), but multitasking efficiency showed only a non-significant trend toward improvement (P = 0.014). In contrast, within the simulated resuscitation, clinical decision-making declined significantly (P = 0.014). Technical skills and other cognitive domains, including memory and planning, did not change significantly after adjustment for multiple comparisons. This pilot study suggests a dissociation between preserved performance on structured cognitive tasks and impaired clinical decision-making following a 24-hour shift. These results suggest that extended work hours may selectively compromise the capacity to manage complex, unstructured clinical situations even when standardised testing remains intact. Our findings identify clinical decision-making as a high-sensitivity marker for future large-scale research into fatigue-mitigation strategies. Approved by the Ethics Committee of the University Hospital of Brussels (UZ Brussel, ref: 2019 − 349, Chairperson prof. M. Deneyer, 23rd October 2019). Clinical trial number: not applicable.
Scholliers et al. (Sat,) studied this question.