ArticleBMC medical education2026
Within-person differences in night-shift burden and well-being after ICU versus non-ICU night shifts among resident physicians: a paired survey study.
Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNight shifts are integral to residency training but may disrupt sleep and recovery. ICU versus non-ICU comparisons are often confounded by between-person differences, and night-shift exposure is often operationalized using simple shift counts rather than more proximal indicators of sleep disruption and recovery.
methodsWe conducted a single-center within-person paired survey study (August 2025-January 2026) in a tertiary teaching hospital. Residents completed the same questionnaire within 24 h after one non-ICU night shift (T1) and after their second ICU night shift (T2). Night-shift burden was assessed using self-reported indicators including duty duration, sleep during the shift, work-related awakenings/calls, and post-shift recovery. Within-person ICU versus non-ICU differences were examined using paired analyses. Associations with emotional exhaustion were evaluated using generalized estimating equations (GEE) with a Gaussian family, exchangeable working correlation structure, robust standard errors, and prespecified burden indicators.
resultsSixty-one residents provided paired responses. Compared with non-ICU night shifts, ICU night shifts were characterized by higher duty duration category (P < 0.001), sleep during the shift shifted toward lower categories (1.95 ± 0.72 vs. 2.72 ± 0.92; P < 0.001), and work-related awakenings/calls shifted toward higher categories (3.39 ± 0.71 vs. 2.79 ± 0.99; P < 0.001). Emotional exhaustion was higher after ICU night shifts (mean paired difference + 3.39; 95% CI 1.00 to 5.79; P = 0.006), and life satisfaction was lower (- 8.90; 95% CI - 11.41 to - 6.40; P < 0.001). In the adjusted GEE model, ICU timepoint remained associated with higher exhaustion (β = 2.94; 95% CI 0.12 to 5.76; P = 0.041), and work-related awakenings/calls were strongly associated with higher exhaustion (β = 3.37; 95% CI 1.37 to 5.38; P < 0.001).
conclusionsWithin the same residents, ICU night shifts were associated with greater night-shift burden and poorer immediate well-being than non-ICU night shifts. These findings should be interpreted in light of the single-center design, modest sample size, self-reported measures, and fixed measurement order. A multidimensional burden framework may help training programs identify modifiable aspects of night duty, including sleep opportunity, interruption load, and recovery time.
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