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Invited Critique
May 2012

Surgical Fatigue—What Dreams May Come: Comment on “Surgeon Fatigue”

Author Affiliations

Author Affiliation: Division of Pediatric Surgery, Hasbro Children's Hospital, and Department of Surgery, Alpert Medical School, Brown University, Providence, Rhode Island.

Arch Surg. 2012;147(5):435-436. doi:10.1001/archsurg.2012.109

There is a lot to like in this study by McCormick and colleagues.1 Its authorship includes one of the best thinkers and doers in this field (Landrigan), with the mentorship of surgical leaders such as Herndon and Rubash. Heretofore, resident fatigue studies demonstrated few good established tools for physiological or cognitive real-time appraisals of fatigue. These authors measured fatigue through individual movement using analytic tools that are applied and validated across several professions and settings, including military and mission-based activity. This is definitely the way to go and provides a credible platform to determine the fatigue patterns of residents and the activities associated with fatigue or performance readiness. Their actual determination of fatigue during certain periods is not startling, but its pervasiveness is a finding we simply cannot avoid and may have paid lip service to in the past. It is unlikely that the data in this study will be refuted.