Late-night simulation: Opinions of fourth- and fifth-year medical students at the University of the Free State, Bloemfontein, South Africa

Background. Sleep deprivation is a problem for medical students and practitioners due to long and late working hours, which may result in a decline in their performance in practising medicine. Objectives. To investigate whether educational practices require altering with regard to the time at which simulation classes are presented, or identify any other possible suggestions for improving the preparation of students for shift work in their profession as medical doctors as a potential solution to reduce sleep-deprivation-related adverse outcomes. Methods. In this quantitative cross-sectional study, an anonymous questionnaire was distributed to 111 fourth-year and 141 fifth-year medical students at the Faculty of Health Sciences, University of the Free State (UFS), Bloemfontein, South Africa, during the second half of 2018. The researchers interpreted the responses and the Department of Biostatistics, UFS, analysed the data. Results. The majority of the fourth-year (88.6%) and fifth-year (90.4%) student groups responded that late-night simulation classes between 01h00 and 04h00 would not be beneficial to their preparation for shift work. The motivation for negative responses was that it might worsen sleep deprivation due to time constraints in an already demanding course. The fourth-year (61.4%) and fifth-year (80.5%) student groups did not regard simulation as realistic and felt that late-night simulation training sessions would not prepare them better for future shift work. However, both groups believed `practice makes perfect' and, as such, their confidence with procedures would improve as they practise more during simulation. Conclusion. The majority of students were negative towards the idea of late-night simulation classes, because of the effect it would have on their already full programme. Students are familiar with the effects of sleep deprivation and felt that late-night simulation classes would add pressure to their busy lives and worsen their sleep deprivation. Further investigation and practical testing would be required to conclude the impact of late-night simulation classes in preparation for shift work of medical doctors and the resultant effect on clinical performance.