{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:29:00Z","timestamp":1790641740920,"version":"4.1.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","funder":[{"name":"Innovation Grant For Quality Improvement"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>\n                      Casino shifts, which end at 4\n                      <jats:sc>AM<\/jats:sc>\n                      and allow sleep during the circadian \u201canchor period,\u201d may improve sleep and reduce fatigue for pediatric emergency medicine (PEM) fellows working night shifts. We hypothesized that using a casino shift model would improve perceived fatigue levels and measured sleep metrics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this pilot prospective observational cohort study, fellows worked traditional night shifts for one month (control) followed by casino shifts for one month (intervention). Sleep data were collected using a validated wrist actigraph (ReadiBand), and subjective perceptions of fatigue were collected using surveys.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eight fellows participated in the study. Compared with the control month, the intervention month was associated with increased sleep quantity and sleep efficiency as measured by the actigraph. Fellows also reported reduced perceived fatigue and improved energy levels during the intervention month.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Switching to a casino shift schedule was associated with improvements in measured sleep and perceived fatigue among a cohort of PEM fellows in this pilot study. These preliminary findings warrant further investigation with larger samples and randomized scheduling to further explore the potential benefits and limitations of casino shift models in emergency medicine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/pec.0000000000003477","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T05:00:20Z","timestamp":1757394020000},"page":"22-27","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["A Pilot Study Using Casino Shifts to Improve Sleep for Emergency Medicine Fellows Working Night Shifts"],"prefix":"10.1097","volume":"42","author":[{"given":"Erika","family":"Cohen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudy J.","family":"Kink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"R1-20251230","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1111\/acem.14606","article-title":"Objective assessment of sleep and fatigue risk in emergency medicine physicians","volume":"30","author":"Fowler","year":"2023","journal-title":"Acad Emerg Med"},{"key":"R2-20251230","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.jsmc.2009.03.001","article-title":"Sleep loss and fatigue in shift work and shift work disorder","volume":"4","author":"Akerstedt","year":"2009","journal-title":"Sleep Med Clin"},{"key":"R3-20251230","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1365-2869.2006.00493.x","article-title":"Fatigue and shift work","volume":"15","author":"Shen","year":"2006","journal-title":"J Sleep Res"},{"key":"R4-20251230","doi-asserted-by":"crossref","first-page":"234","DOI":"10.3390\/clockssleep5020019","article-title":"Shift happens: emergency physician perspectives on fatigue and shift work","volume":"5","author":"Klinefelter","year":"2023","journal-title":"Clocks Sleep"},{"key":"R5-20251230","doi-asserted-by":"crossref","first-page":"2571","DOI":"10.2147\/RMHP.S311638","article-title":"Medication error during the day and night shift on weekdays and weekends: a single teaching hospital experience in riyadh, saudi arabia","volume":"14","author":"Aljuaid","year":"2021","journal-title":"Risk Manag Healthc Policy"},{"key":"R6-20251230","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1345\/aph.1P252","article-title":"Nighttime and weekend medication error rates in an inpatient pediatric population","volume":"44","author":"Miller","year":"2010","journal-title":"Ann Pharmacother"},{"key":"R7-20251230","doi-asserted-by":"crossref","first-page":"e21462","DOI":"10.1097\/MD.0000000000021462","article-title":"Burnout in emergency medicine physicians: a meta-analysis and systematic review","volume":"99","author":"Zhang","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"R8-20251230","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1111\/j.1553-2712.1996.tb03379.x","article-title":"Burnout and its correlates in emergency physicians: four years\u2019 experience with a wellness booth","volume":"3","author":"Goldberg","year":"1996","journal-title":"Acad Emerg Med"},{"key":"R9-20251230","doi-asserted-by":"crossref","first-page":"2065","DOI":"10.1001\/archinte.1991.00400100131022","article-title":"Effect of a change in house staff work schedule on resource utilization and patient care","volume":"151","author":"Gottlieb","year":"1991","journal-title":"Arch Intern Med"},{"key":"R10-20251230","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1113\/jphysiol.1983.sp014988","article-title":"Does \u2018anchor sleep\u2019 entrain circadian rhythms? 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